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Abstract: A 23-kg, 3-year-old spayed female boxer was admitted for evaluation of a traumatic partial amputation of the fourth digit of the right front limb. The injuries were self-induced by the dog trapping the legs under a metallic fence. The dog had multiple lacerations on both front limbs and a partial amputation of the right front fourth digit. The dog otherwise appeared to be healthy. Methods and Results. The multiple lacerations were treated with repeated wet-to-dry bandages followed by non-adherent bandages on the established granulation bed. Epithelization of the numerous superficial skin lacerations was noted within 7 to 10 days. Initial management of the digital injury was unsuccessful. In spite of the aggressive medical and surgical treatment, the deep laceration progressively worsened. Serial attempts to debride the necrotic subcutaneous and muscular tissues failed to result in granulation. Maggot debridement was considered as a last resort of treatment following limited progress with tissue healing and the owner firmly declining the amputation of the digit. The treatment consisted of a single continuous application of sterile larvae over the open wound for 3 days to debride the necrotic tissues through the proteolitic action of maggot secretions, while sparing the surrounding live structures. When the complete maggot debridement was achieved, medical grade leeches were used for four consecutive applications 12 hours apart to control venous congestion. At the end of the treatment the wound was healed and completely re-epithelialized. Conclusion. Maggot debridement and leech therapy were used as alternative wound management of a nonhealing traumatic partial amputation of a digit in a dog. The treatment was safe, successful, and efficient for a difficult wound in a challenging anatomical location.

  In dogs, laceration and partial amputation injuries of digits are common lesions resulting from crushing or digit-trapping accidents.¹ The severity of the lesion depends on the anatomical location, level of contamination, extent of vascular injury, and presence or absence of deep tissue or orthopedic trauma.² Because of their role as primary weight-bearing digits, third and fourth digital amputations may have a poorer prognosis than other digit injuries, and cause more significant gait abnormalities.^3,4 For this reason numerous medical and surgical procedures, have been described in order to preserve or replace weight-bearing digits.¹ Non-surgical treatments include autolytic or enzymatic debridement, wet-to-dry dressings, and negative pressure wound therapy (NPWT). Several surgical reconstruction techniques have also been reported, including local or distant flaps, free grafts, or digital pad transfers.⁵ Independently from the chosen type of management, negative prognostic factors attributed to failure of effective digital salvage are presence of infection, tissue necrosis, and inadequate circulation.¹ Decreased availability of vital tissue and inadequate blood flow impede a successful surgical debridement and also prevent systemic or topical antibacterials from reaching the targeted site.