Plus-Hex CLINICAL of bacterial isolates were identified across wounds, potentially influenced by local factors specific to the different hospitals.
Overall, Nolff et al. [ 17 ] provide supportive evidence of NPWT decreasing the time to wound closure, with findings also secondarily suggesting that NPWT may lead to faster wound closure than conventional bandages, although further research should investigate a direct comparison of these treatments. However, as well as its retrospective nature, variations in dressing technique and wide variations in the isolated bacteria are limitations to the strength of the evidence.
The research of Nolff et al. [ 17 ] was built on in another study by Nolff et al. [ 19 ], which aimed to further assess the effect of NPWT, compared with SCFDs, on the treatment of open wounds in dogs. Wounds( n = 26) were paired( 13 pairs) based on conformation, localisation and underlying cause, and compared in terms of time to closure, bacterial bioburden, complications and wound contraction. Blinding was not possible due to recognisable patterning created by the NPWT systems. The implementation of a prospective methodology allowed better control of variables within the study, as well as more accurate pairing of wounds, a noted weakness of the earlier study [ 17 ].
Dressings were changed every 3 days for 9 days, although saturated dressings were changed early and recorded. Both groups received wound lavage with polyhexanide biguanide at dressing changes. An analgesia protocol was implemented to restrict variation; administration of non-steroidal anti-inflammatory drugs and cortisol was not permitted. Strict standardisation, such as that demonstrated in this study, minimises variation outside the primary treatment, contributing to a robust methodology and bolstering the strength of the study. All patients were followed up for a minimum of 3 weeks postoperatively, and owners were contacted prior to publication of the study to determine the development of any further complications. Nolff et al. [ 19 ] excluded cases that developed life-threatening complications or wound breakdown. Exclusion of unsuccessful cases limits the generalisability of the findings, as it cannot be definitively stated whether there is a significant link between these outcomes and the treatment received.
Nolff et al. [ 19 ] reported that wounds treated with NPWT healed significantly faster than wounds treated with SCFDs( 14.2 days vs 28.7 days; p = 0.018), had a significantly superior reduction in size at all time points( p = 0.001, 0.006, 0.011, respectively), and had significantly less necrosis and deterioration at day 6( 2 / 13 vs 9 / 13; p = 0.004). No significant difference was detected between the groups in bacterial culture, rates of complications or total achievement of wound closure. Notably, one dog receiving the control treatment was reported to have severe complications, which resolved once the dog was unenrolled from the study and treated with NPWT. On average, despite more expensive wound treatment, the total cost of treatment for NPWT patients was 3.6 % less than for control patients, which the authors attributed to complications in the control group requiring more extensive management. It is not stated whether this difference is significant; however, the benefit-to-cost ratio of NPWT could be researched further. Overall, beneficial outcomes, supported by strict methodological standardisation, present this study as robust evidence for the use of NPWT.
Emergent research
Research on the use of NPWT in canine patients has changed in recent years, with studies emerging that investigate the efficacy of novel NPWT systems. Garcia-Pertierra et al. [ 20 ] assessed the use of a single-use, canister-free, portable NPWT( P-NPWT) device in eight canine and three feline cases. This study found that the device was effective on wounds in large, flat areas, such as those on the trunk, abdomen or back, but frequently lost vacuum when used on curved surfaces, such as the groin. Despite this, all patients achieved full recovery, with P-NPWT being well tolerated in all cases. Building on this work, Freire et al. [ 21 ] aimed to further assess the feasibility of P-NPWT for wound healing compared with conventional dressings, using paired 2 cm × 2 cm wounds on canine thoraxes. The results showed that control wounds granulated slightly faster than those in the P-NPWT group, although the granulation tissue that formed in control wounds was far more irregular. This study also reported difficulties maintaining a vacuum with P-NPWT systems, and the authors suggest that the results contraindicating the use of the P-NPWT system may be due to this complication.
While evidence trends towards NPWT having a positive effect on wound healing, further research is required in the use of emergent P-NPWT systems in the veterinary sector.
Conclusions
Current evidence indicates that NPWT during canine wound management promotes superior wound healing to both conventional and silver-impregnated dressings. However, the paucity of larger-scale, randomised, controlled research limits the strength of this evidence, preventing definitive validation of its superiority. Despite the existence of findings in human and animal models, insufficient evidence supports NPWT having a significant effect on bacterial bioburden in canine patients.
NPWT is generally well tolerated, although care should be taken to monitor pain, due to reported discomfort. It is suitable for the treatment of a range of wound types, including open wounds, high-risk surgical wounds and burns, and alongside extensive debridement in the management of necrotising fasciitis.
Volume 41( 1) • February 2026
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