Disposable negative pressure wound therapy system enhances punch graft acceptance in equine distal limb wounds

This case series describes the use of a disposable, canister-free negative pressure wound therapy (NPWT) system (PICO®) in combination with punch grafting for the treatment of distal limb wounds in three horses. Each horse presented with complex traumatic injuries resulting in delayed or inadequate healing of distal limb wounds. In all three cases, 6 mm full-thickness skin punch grafts were harvested from the neck and implanted into appropriately prepared wound beds. The PICO® system was applied post-operatively to support graft adherence and reduce complications such as infection. Bandage changes were performed between days 3 and 5, with NPWT maintained for up to 13 days. In all cases, the majority of grafts were successfully incorporated, with no signs of pain or adverse reactions to the NPWT system. Full epithelialisation was observed within 3–5 weeks post-grafting. The lightweight, user-friendly design of the PICO® system allowed for easier application compared to conventional NPWT systems and was well tolerated by the patients. These findings suggest that this method is a practical and effective adjunct to improve graft survival in the management of equine distal limb wounds.