title: Surgical amputation of a digit and vacuum-assisted-closure (V.A.C.) management in a case of osteomyelitis and wound care in an eastern black rhinoceros (Diceros bicornis michaeli).
abstract: A 14-yr-old female eastern black rhinoceros (Diceros bicornis michaeli) presented with progressive suppurative osteomyelitis in her left hind lateral toe. beta-Hemolytic Streptococcus sp. was isolated. The animal was treated with multiple systemic antibiotics, and topical wound cleansing. Repeated debridements and nail trimmings were performed for 5 mo prior to electing amputation. The toe was surgically amputated under general anesthesia between the first and second phalanges. Analgesia was diffused into the wound topically via a catheter and elastomeric pump. The open amputation site was covered with adherent drapes and a negative-pressure wound therapy device provided vacuum-assisted closure (V.A.C.) for 72 hr. Three months later this animal developed a deep dermal ulcer on the lateral aspect of the right hind limb, at the level of the stifle. Methicillin-resistant Staphylococcus aureus was isolated. The wound was managed by initial daily lavage, followed by 1 mo of V.A.C. therapy, with 72 hr between dressing changes. Clinically, this therapy expedited the formation of healthy granulation tissue and overall healing was accelerated. The animal tolerated the machine and bandage changes well via operant conditioning. The use of negative-pressure wound therapy appeared to shorten time to resolution of slow-healing wounds in black rhinoceros.
authors.affiliation: Potter Park Zoo, 1301 South Pennsylvania, Lansing, Michigan 48912, USA. taramharrison@gmail.com
authors.forename: Tara M
authors.initials: TM
authors.lastname: Harrison
authors.forename: Bryden J
authors.initials: BJ
authors.lastname: Stanley
authors.forename: James G
authors.initials: JG
authors.lastname: Sikarskie
authors.forename: George
authors.initials: G
authors.lastname: Bohart
authors.forename: N Kent
authors.initials: NK
authors.lastname: Ames
authors.forename: Janice
authors.initials: J
authors.lastname: Tomlian
authors.forename: Mark
authors.initials: M
authors.lastname: Marquardt
authors.forename: Annabel
authors.initials: A
authors.lastname: Marcum
authors.forename: Matti
authors.initials: M
authors.lastname: Kiupel
authors.forename: Dodd
authors.initials: D
authors.lastname: Sledge
authors.forename: Dalen
authors.initials: D
authors.lastname: Agnew
mesh_terms: D000671:Amputation, Surgical / Q000662:veterinary*; D000818:Animals; D005260:Female; D006614:Hindlimb / Q000601:surgery*; D054843:Negative-Pressure Wound Therapy / Q000662:veterinary*; D010019:Osteomyelitis / Q000601:surgery / Q000662:veterinary*; D010527:Perissodactyla / Q000601:surgery*; D013290:Streptococcal Infections / Q000601:surgery / Q000662:veterinary; D014034:Toes / Q000601:surgery*; D014945:Wound Healing