Negative-Pressure Wound Therapy (NPWT) in Horses: A Scoping Review

SIMPLE SUMMARY: Wounds have a major impact on horses’ welfare and they can be a clinical challenge for practitioners. It is recognized that horses may experience delayed healing and the formation of exuberant granulation tissue. Negative-pressure wound therapy (NPWT) is a technique often employed in humans to enhance wound healing. It refers to the use of sub-atmospheric pressure obtained by a portable pump attached to a canister. However, the existing evidence for the effectiveness of NPWT remains uncertain in equine medicine. The aim of this review is to investigate NPWT applications and benefits concerning horses. The information obtained helps to provide recommendations for the use of this technique in practice. A review is performed and 24 manuscripts are considered. Fifteen manuscripts met the inclusion criteria. The focus of the articles was wound management, traumatic wounds, and surgical-site infections, including synovial structures as indications for NPWT. NPWT presents several advantages and few complications making it an attractive alternative to conventional wound management. However, randomized controlled trials should be performed to quantify the benefits and establish precise protocols in horses, which are lacking in the literature at present. ABSTRACT: Obtaining a healthy wound environment that is conductive to healing in horses can be challenging. Negative-pressure wound therapy (NPWT) has been employed in humans to enhance wound healing for decades. The existing evidence for the effectiveness of NPWT remains uncertain in equine medicine. The aim of this review is to investigate NPWT applications and benefits in horses. A scoping review was performed according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines for scoping reviews on three databases (PubMed, Web of Science-Thompson Reuters, and Wiley Online Library). Twenty-four manuscripts were considered. After removing duplicates, 17 papers underwent abstract screening. Of these, 16 + 1 (cited by others) were evaluated for eligibility according to PICOs, including no case reports/retrospective studies, four original articles, and three reviews. Fifteen manuscripts met the inclusion criteria. The focus of the articles was wound management; they included three reports of wounds communicating with synovial structures. Traumatic wounds and surgical-site infections are indications for NPWT. NPWT presents several advantages and few complications making it an attractive alternative to conventional wound management. However, randomized controlled trials should be performed to quantify the benefits and establish precise protocols in horses.