Disposable negative pressure wound therapy system enhances punch graft acceptance in equine distal limb wounds
Authors: Schnierer M., Haralambus R. M. A., Florczyk A.
Journal: Equine Veterinary Education
Summary
# Editorial Summary When traumatic injuries compromise the healing capacity of equine distal limb wounds, punch grafting offers a viable reconstructive option, yet graft incorporation remains unpredictable without optimal wound bed conditions. Schnierer and colleagues applied a disposable negative pressure wound therapy system (PICO®) as an adjunctive treatment in three horses receiving 6 mm full-thickness punch grafts harvested from the neck, maintaining therapy for up to 13 days with bandage changes between days 3 and 5. All three cases achieved successful graft incorporation with full epithelialisation within 3–5 weeks, notably without infection or adverse reactions attributable to the NPWT device. The PICO® system's canister-free design proved more practical and user-friendly than conventional NPWT alternatives, factors that facilitate compliance in clinical settings where repeated bandaging and patient tolerance are genuine constraints. For practitioners managing chronic or complex distal limb injuries in horses, this approach warrants consideration as an evidence-informed method to enhance graft take rates and accelerate return to functional healing, particularly where conventional wound management has plateaued.
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Practical Takeaways
- •Consider PICO® negative pressure wound therapy as an adjunct to punch grafting for complex distal limb wounds—it improved graft acceptance and reduced infection risk in these cases.
- •The lightweight, canister-free design makes NPWT more practical for field application and horse tolerance, with bandage changes only needed every 3–5 days.
- •This combination approach may accelerate healing in difficult-to-manage distal limb injuries where conventional treatment has been unsuccessful.
Key Findings
- •PICO® negative pressure wound therapy system combined with punch grafting achieved successful graft incorporation in all three horses with complex distal limb wounds.
- •Majority of full-thickness skin grafts were successfully incorporated with no adverse reactions or pain responses to the NPWT system.
- •Full epithelialisation occurred within 3–5 weeks post-grafting with NPWT maintained for up to 13 days.
- •Disposable PICO® system was more user-friendly and easier to apply than conventional NPWT systems, improving clinical practicality.