Negative Pressure Wound Therapy for Horses

Depending on the severity of the trauma, wounds on horses can take weeks to heal. Even after fastidious care, the outcome may not be aesthetically pleasing, with excessive scarring or formation of proud flesh a common result. In an effort to find an alternative treatment that may hasten healing with less scarring, researchers looked into negative pressure wound therapy (NPWT).

Instead of relying solely on sutures, bandages, salves, and skin grafts, some experts extol the advantages of NPWT.^* Applying subatmospheric pressure either continuously or intermittently to wounds:

• Reduces discharge and swelling;
• Increases blood flow to the injured tissues;
• Enhances normal granulation tissue formation that lays the foundation for wound healing; and
• Decreases the number of bacteria in the wound, potentially limiting the need for antibiotics.

Review of medical records from 42 horses treated with NPWT indicated the procedure was well tolerated by most horses, resulting in satisfactory outcomes in the majority of patients.

“While older NPWT units were large and cumbersome, modern units are not much larger than many smartphones,” explained David Nash, director of nutrition technology at Kentucky Equine Research.

“To create a subatmospheric pressure of around 125 mmHg on the wound, a great deal of preparation of the wound area is required,” he said. “A special foam, proprietary cellophane, drainage tubes, and bandaging are necessary to ensure a long-lasting seal on the wound. The unit is then connected to the drainage tube to create the vacuum/negative pressure.”

The current study showed that the NPWT unit can be left in place for up to 7 days before resetting the system. Total treatment time for horses ranged from 2 to 36 days, with a median treatment time of about 12 days. Horses tolerated NPWT well.

A large variety of wounds are responsive to this therapy, according to this retrospective study, including muscle and skin injuries as well as those with bone or joint involvement. Damaged tenosynovial structures—anatomical points in which tendons are bathed in synovial fluid—also responded to therapy.

Experts recommend using NPWT early in the healing process, though owners should understand that the therapy is expensive currently.

“Bio-Bloom has key ingredients that assist with cellular integrity of the skin during wound healing. Those ingredients include biotin, methionine, and trace minerals such as chelated zinc and copper. This formulation also promotes high-quality hair growth,” explained Nash.

^*Launois, T., P.-L. Moor, A. Berthier, N. Merlin, F. Rieu, C. Schlotterer, A. Siegel, G. Fruit, A. Dugdale, and J.-M. Vandeweerd. 2021. Use of negative pressure wound therapy in the treatment of limb wounds: a case series of 42 horses. Journal of Equine Veterinary Science 106:103725.