Arai Shiori, Coryell Jessi, Johnson Tiffany, Chow Rosalind S, Amsellem Pierre M
Veterinary Clinical Sciences Department, College of Veterinary Medicine, University of Minnesota, 1352 Boyd Avenue, St. Paul, Minnesota 55108, USA.
Can Vet J. 2025 Jan;66(1):51-57.
A 6-year-old Labrador retriever dog with a history of pneumonia was presented because of an acute onset of dull mentation and coughing. Diagnostic imaging and cytology revealed a pneumothorax, pneumomediastinum, and pleural effusion, consistent with pyothorax. The dog underwent exploratory sternotomy for lung lobectomy of the right cranial and middle lung lobes. Persistent pneumothorax and pleural effusion were present after surgery, and the sternotomy site dehisced 6 d postoperatively. A second CT scan revealed persistent consolidation of the left cranial lung lobe and continued pneumothorax and pleural effusion. A left cranial lung lobectomy was done on the 8th day following initial surgery. An incisional infection was determined to be associated with multidrug-resistant infection. Due to persistent pleural and incisional drainage, a third exploratory sternotomy was required, which revealed dehiscence of the surgical site and an unstable sternal repair with fractured sternebrae. The sternotomy site was left partially closed and negative pressure wound therapy (NPWT) was applied. No complications with NPWT were encountered, and the incision healed appropriately. Key clinical message: This is the first documented description of the use of NPWT in a dog to successfully manage a partially closed sternotomy and resolve a multidrug-resistant infection of the sternotomy site.
一只6岁的拉布拉多猎犬因肺炎病史前来就诊，此次因突然出现精神沉郁和咳嗽。诊断性影像学检查和细胞学检查显示气胸、纵隔气肿和胸腔积液，符合脓胸表现。该犬接受了胸骨切开术，对右侧颅叶和中叶进行肺叶切除术。术后持续存在气胸和胸腔积液，胸骨切开部位在术后6天裂开。第二次CT扫描显示左颅叶持续实变，气胸和胸腔积液仍存在。在初次手术后第8天进行了左颅叶肺叶切除术。确定切口感染与多重耐药感染有关。由于胸腔和切口持续引流，需要进行第三次胸骨切开探查术，结果显示手术部位裂开，胸骨修复不稳定，有胸骨节段骨折。胸骨切开部位部分敞开，应用负压伤口治疗（NPWT）。未遇到NPWT相关并发症，切口愈合良好。关键临床信息：这是首次有文献记载在犬中使用NPWT成功处理部分敞开的胸骨切开术并解决胸骨切开部位多重耐药感染的描述。
