V.A.C.TM therapy in an Italian Friesian calf

Vacuum Assisted Closure (V.A.C.) is a non-invasive therapy based on the application of negative pressure by controlled suction to the wound surface. V.A.C. has been widely employed in human medicine for over a decade; its use in animals is limited in pets and horses and, to our knowledge, it has not been described in cattle yet. The principles of this therapy are based on the delivery of subatmospheric pressure to the wound bed through an open pore sponge dressing, that is placed in the wound and covered with plastic adhesive drape. The application of negative pressure to the foam has been proved to be effective in improving the development of granulation tissue, decreasing of tissue edema, reducing bacterial colonization of tissues and decreasing rapidly the wound area. The aim of the paper is to describe the first utilization of V.A.C. in a calf with a large infected wound on the left hindlimb. A one-month-old female Italian Friesian calf was admitted to our clinic for a large wound on the left hindlimb in October 2011. History reported that the calf presented a grade 2 congenital arthrogryposis of both forelimbs. The prolonged recumbency caused by this pathology induced the compression of the skin of the left hindlimb resulting in skin necrosis and consequently in an infected large plague that extended from the dorsal surface of the knee area up to the tibio-tarsal area. Traditional methods would have likely failed with a such severe wound, therefore the use of V.A.C. was preferred. The patient underwent surgical debridement and application of the V.A.C. The skin area around the wound was cleaned, clipped and aseptically prepared. A reticulated 400-600 μm pore polyurethane foam dressing was applicated on the wound. It was then covered with an adhesive plastic drape, where a 1 cm hole was created in order to apply a trackpad connected with a computer-controlled therapy unit that allows continuous, controlled application of subatmospheric pressure of 125 mmHg. The area surrounding the wound was protected with a classic bandage. The calf was subjected to a long antibiotic therapy till the almost complete healing of the wound. Every 3 days the wound was medicated. The present report describes the first use of the V.A.C. in cattle. The clinical outcome was excellent although we recommend the V.A.C. therapy only in selected high value patients.