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Vacuum-assisted closure for treatment of a deep shell abscess and osteomyelitis in a tortoise

Michael J. Adkesson DVM1,2, Erika K. Travis DVM3,4, Martha A. Weber DVM, DACZM5, John P. Kirby MD6, and Randall E. Junge MS, DVM, DACZM7
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  • 1 Saint Louis Zoo, 1 Government Dr, St Louis, MO 63110
  • | 2 Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, MO 65211
  • | 3 Saint Louis Zoo, 1 Government Dr, St Louis, MO 63110
  • | 4 Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, MO 65211
  • | 5 Saint Louis Zoo, 1 Government Dr, St Louis, MO 63110
  • | 6 School of Medicine, Washington University, St Louis, MO 63110
  • | 7 Saint Louis Zoo, 1 Government Dr, St Louis, MO 63110

Abstract

Case Description—A female Aldabra tortoise (Geochelone gigantea) was evaluated because of focal necrosis of the carapace.

Clinical Findings—Debridement revealed a 14.5 × 11.5-cm area of shell necrosis, deep abscess formation, and osteomyelitis involving bacterial (Klebsiella pneumoniae, Staphylococcus aureus, and Pseudomonas spp) and fungal pathogens.

Treatment and Outcome—Following extensive debridement, vacuum-assisted closure incorporating silver-impregnated bandaging materials was used. The wound was considered healed after 55 days, at which time a layer of epidermal tissue with progressing keratinization was present, with smooth underlying ossification. Keratinization with normal pigmentation continued over the next 67 days.

Clinical Relevance—Findings suggested that vacuum-assisted closure with silver-impreg-nated bandaging materials may provide advantages over traditional methods in the treatment of shell lesions in chelonians, including faster wound healing, improved cosmetic appearance of the healed wound, superior control of microbial contamination, and lower overall treatment costs.

Contributor Notes

Dr. Travis' present address is Utah's Hogle Zoo, 2600 E Sunnyside Ave, Salt Lake City, UT 84108.

The vacuum-assisted closure device and dressings were donated by Kinetic Concepts Inc.

Address correspondence to Dr. Adkesson.