Innovation

Wound Soaker Catheters

At the Foster Hospital for Small Animals and Tufts Veterinary Emergency Treatment and Specialties (Tufts VETS), we have been using wound soaker catheters routinely since 2004 for infusion of lidocaine (dogs) and intermittent bupivacaine injection in cats after a variety of procedures. These include  limb amputation, ear canal ablation, intercostal and sternal thoracotomy, celiotomy, and soft tissue tumor excision.

This dog, shown the evening after a thoracotomy, has a wound soaker catheter placed in a median sternotomy incision. Both the wound soaker (lowermost) and thoracic drain (uppermost) can be seen. He is ambulatory and comfortable.

Two of our anesthesiology/pain medicine specialists, Dr. Emily McCobb and Dr. Cheryl Blaze, collaborated with experts at Mila International (Erlanger, KY) to develop the competitively priced veterinary catheters. Qualitatively, we find that the pain relief afforded to patients is excellent. Dogs recovering from an intercostal thoracotomy will lie on the side of the incision, which suggests that they are quite comfortable. Perhaps the most compelling application is the use of wound soakers for limb amputation. In fact, the use of wound soaker catheters has become a common and preferred amputation pain management technique in many hospitals. Patients are comfortable upon recovery from anesthesia, will stand, walk and eliminate with ease, and generally will eat the first postoperative night.

It should be emphasized that we continue to use pre-, intra-, and postoperative multimodal analgesia, consisting of an intravenous opioid, ketamine or alpha 2 agonist infusion, and NSAIDS and/or epidural analgesia along with the wound soakers. However, we are able to reduce the amount of opioid medications and sedatives significantly.  (See figures for views of patients managed with wound soaker catheters.)

The evening after forelimb amputation this dog is ambulatory and hungry. The infusion line seen in the foreground leads to her wound soaker and is labeled with a red lidocaine tag. She is slightly sedate from her anesthesia medications.

In 2009, our group published a case series reviewing our experiences with the safety of the technique:

This dog, shown the day after a thoracotomy, has a wound soaker placed in the intercostal incision. She is interactive and comfortable.

Abelson AL, McCobb EC, Shaw S, Armitage-Chan A, Wetmore LA, Karas AZ and Blaze C. (2009) Use of wound soaker catheters for the administration of local anesthetic for post-operative analgesia: 56 cases. Veterinary Anaesthesia and Analgesia. 36:597–602.

A study comparing recovery and rehabilitation pain in patients with and without wound infusion of local anesthetics is ongoing at the FHSA.