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1.
Three dogs were presented for the management of disease processes resulting in large skin defects over the dorsal lumbosacral region. One had severe dog bite wounds, one had a large burn sustained from a heating pad and one had a large myxosarcoma in the region. In each case, the extent and location of the resulting skin defect were assessed as factors likely to prevent reconstruction using simple tension-relieving techniques alone or in combination with established reconstructive techniques, such as axial pattern flaps or skin stretching devices. Bilateral skin fold rotation-advancement flaps (SFRAFs) based on the flank folds were mobilised dorsally and allowed complete wound closure in two dogs and subtotal closure in the other dog. All wounds healed without major complications and an acceptable cosmetic outcome was achieved in each case. Minor flap debridement was required in two dogs. The use of bilateral SFRAFs is a useful technique alone or in combination with other reconstructive techniques for the closure of large dorsal lumbosacral skin defects when existing techniques are not sufficient. Small flank folds, such as those of obese dogs, may yield unexpectedly large SFRAFs.  相似文献   

2.
OBJECTIVE: To evaluate the use of subdermal plexus skin flaps for closing defects after excision of cutaneous and subcutaneous tumors in dogs and to compare outcome of flaps secured with sutures and those secured with butyl-cyanoacrylate and intermittent sutures. STUDY DESIGN: Clinical study. ANIMALS: Fifteen dogs. METHODS: After excision of cutaneous or subcutaneous tumors the skin defect was reconstructed by random flaps based on the subdermal plexus. Flap skin edges were apposed with simple interrupted 4-0 monofilament nylon sutures (group 1; 5 dogs) or nylon sutures alternated with butyl-cyanoacrylate adhesive (group 2; 10 dogs). Flaps were evaluated every 48 hours when bandages were changed, until complete healing. RESULTS: Random flaps based on the subdermal plexus were effectively used to close wound defects; mean flap survival was 89%. Partial flap necrosis occurred in 4 dogs. Wound margins apposed with butyl-cyanoacrylate had thinner and more esthetic scars than sutured margins. CONCLUSION: Random flaps based on the subdermal plexus proved to be versatile for covering limb wounds after excision of cutaneous or subcutaneous tumors. Mean survival rate was comparable to that reported for axial pattern flaps. Butyl-cyanoacrylate adhesive was easy to apply, allowed accurate margin apposition with good cosmetic outcome and reduced sutures needed. CLINICAL RELEVANCE: Cyanoacrylate adhesive should be considered in lieu of suture closure to secure random skin flaps based on the subdermal plexus in dogs.  相似文献   

3.
The treatment of large skin defects of the distal limbs of dogs and cats can be difficult due to the lack of skin available for primary wound closure or the creation of local skin flaps. Distant pedicle skin flaps provide an acceptable alternative for wound closure with full thickness skin and provide a cosmetic result. Fourteen animals (10 dogs and four cats) that had distant pedicle skin flaps are reviewed. The technique allowed 100 per cent wound coverage in 10 of 14 animals and greater than 95 per cent skin flap survival occurred in 12 of 14 animals. Complications associated with the procedure were most commonly wound infection and partial suture line dehiscence, however these did not detract from the final outcome. Flap release was in one or two stages, however the outcomes did not appear to be affected by the release protocol.  相似文献   

4.

Purpose

To describe the surgical technique and clinical outcomes of the glabellar flap and its modification for the reconstruction of the medial canthus following resection of tumors in three dogs and two cats.

Methods

Three dogs (7-, 7-, and 12.5-year-old mixed breeds) and two cats (10- and 14-year-old Domestic shorthair) presented with a 7–13 mm tumor affecting the eyelid and/or conjunctiva in the medial canthal region. Following en bloc mass excision, an inverted V-shaped skin incision was made in the glabellar region (i.e., the area between the eyebrows in humans). The apex of the inverted V-shaped flap was rotated in three cases, whereas a horizontal sliding movement was performed in the other two cases to better cover the surgical wound. The surgical flap was then trimmed to fit the surgical wound and sutured in place in two layers (subcutaneous and cutaneous).

Results

Tumors were diagnosed as mast cell tumors (n = 3), amelanotic conjunctival melanoma (n = 1), and apocrine ductal adenoma (n = 1). No recurrence was noted in a follow-up time of 146 ± 84 days. Satisfactory cosmetic outcome with normal eyelids closure was achieved in all cases. Mild trichiasis was present in all patients and mild epiphora was noted in 2/5 patients, but there were no associated clinical signs such as discomfort or keratitis.

Conclusions

The glabellar flap was easy to perform and provided a good outcome in terms of cosmetic, eyelid function, and corneal health. Postoperative complications from trichiasis appear to be minimized by the presence of the third eyelid in this region.  相似文献   

5.
OBJECTIVE: To determine applicability and size limits of an axial pattern flap based on the lateral caudal arteries in dogs to reconstruct caudodorsal trunk skin defects. STUDY DESIGN: Experimental study. ANIMALS: Ten mature, mixed breed dogs. METHODS: The lateral caudal vessels of the tail were incorporated in the flaps of the treatment group (n=5) and were ligated in the control group (n=5). Flaps were rotated and placed into experimentally created caudodorsal skin defects on the trunk. The length and area of tissue that remained viable in each flap were determined. RESULTS: Mean (+/-SD) survival area (222.8+/-32.9 cm2) and length (25.1+/-4.5 cm) of vascularized flaps were significantly greater (P<.05) compared with control flaps (94.9+/-13.4 cm2 and 14.61+/-4.7 cm). Necrosis occurred in all control flaps, resulting in lower percentage flap area (48.8%) and length (47.1%) survival compared with vascularized flaps (78.1%, 77.5%). CONCLUSIONS: Axial pattern flap based on lateral caudal arteries of the tail was successfully elevated and transferred in a single procedure, with 78% survival for closure of large experimentally created caudodorsal trunk defects in dogs. CLINICAL RELEVANCE: Large cutaneous defects of the caudodorsal trunk area in dog could be reconstructed with tail axial pattern flap. Limitations in terms of size and changes in animal appearance have to be considered before flap elevation.  相似文献   

6.
In phase I, tissue expanders were implanted subcutaneously over the lateral crural region of four dogs. The expanders were inflated daily to maintain a constant intraluminal pressure for 7 days. All animals tolerated the pressurized expanders well. Some animal patient discomfort was associated with repeated injections into the subcutaneous filling port. One dog developed a limited area of tissue loss and exposure of the expander. Tissue response to the expanders included epidermal hyperplasia, dermal collagen compression with early fibroplasia, and subcutaneous granulation tissue formation adjacent to the expander pocket. In phase II, a second group of four dogs underwent rapid skin expansion over 7 days. The pressure applied to the expanding skin was determined daily and adjusted to approximate the value reported for capillary pressure in the dog. Tissue discoloration occurred in two dogs, suggestive of impaired circulation. Skin flaps were developed from expanded skin and rotated over the talocrural region. Wound dehiscence occurred along the distal flap margin in three phase II dogs. These wounds healed by second intention. Branches of the caudal saphenous artery were identified, using angiography, as the primary blood supply to the skin flaps.  相似文献   

7.
Skin expansion was used in three horses, one heifer, and one dog to aid in the repair of cosmetic defects. Skin expansion was produced by inserting an expandable silicone device subcutaneously and gradually inflating the device with saline. Skin expansion allowed skin to be mobilized and sutured over cosmetic defects without excessive tension. A successful outcome was achieved in four of the five cases reported here. In one animal, two attempts to create a pocket for a silicone prosthesis failed because the expanders ruptured. Complications included implant failure, wound dehiscence, and exposure of an expander. Skin expansion can be used to enable closure of skin defects in areas where skin tension usually precludes repair by local transposition.  相似文献   

8.
Reconstruction of facial defects can be very challenging, even in the hands of an experienced surgeon. Most defects can be repaired using local available tissues. Lip defects can be reconstructed using geometric closure techniques and advancement of local tissues. Forehead defects can be reconstructed using skin grafts, caudal auricular flaps, or rotational or transposition flaps. Care must be taken to minimize tension on eyelids and maintain the integrity of the facial nerve. Cheek defects can be reconstructed using local advancement, superficial temporal, omocervical, and caudal auricular flaps. The bridge of the nose can be very difficult to reconstruct due to a paucity of local tissues; however, skin grafts, indirect pedicle flaps, and superficial temporal flaps can be considered. .  相似文献   

9.
Myocutaneous and muscle flaps provide an added dimension to reconstructive surgery in small animals. Myocutaneous flaps composed of a muscle unit and the overlying skin can be utilized for skin wound closure, especially when the additional bulk of the transplanted muscle can be utilized for padding or closure of body cavities. Alternatively, muscle units alone can be employed for a variety of conditions, including closure of defects of the thorax and abdominal cavities and management of chronic bone infections. They also facilitate bone healing when delayed unions and nonunions occur. This article discusses the newer myocutaneous flaps and muscle flaps clinically applicable in small animal surgery.  相似文献   

10.
Nineteen axial pattern skin flaps were used in 16 dogs and cats to provide skin for repair of extensive cutaneous defects. Retrospective evaluation of medical records was used to determine percentage flap survival, postoperative complications, and long-term outcome of axial pattern skin flaps. The most common indication for use of axial pattern flaps was to augment wound closure following tumor resection (n = 7). Other indications included trauma (n = 5), chronic nonhealing wounds (n = 4), urine-induced cellulitis (n = 1), idiopathic dermal necrosis (n = 1), and chronic lymphoplasmocytic dermatitis (n = 1). Mean flap survival (+/- SD) was 96% (+/- 8). Postoperative complications included wound drainage (n = 15), partial dehiscence of the sutured flap (n = 7), distal flap necrosis (n = 6), infection (n = 3), edema (n = 3), and seroma formation (n = 2). After a median follow-up time of 5 months, evaluation of animals indicated that surgery provided successful wound reconstruction with good cosmetic results. Reconstruction of large cutaneous defects is facilitated by axial pattern flap application regardless of cause of wound. Postoperative complications are common but amenable to standard wound management techniques such as drain placement and surgical debridement of devitalized distal flap skin.  相似文献   

11.
Management of large trunk wounds begins with good wound management and bandaging. When a healthy wound bed exists and adequate tissue is present, the wound is closed. Fortunately, there is an abundance of loose trunk skin in most animals, and wound closure can be accomplished by simple reconstructive techniques, such as undermining and tension or "walking sutures." Nevertheless, some wounds and areas of the torso may require more advanced tension-relieving techniques, skin stretching, and tissue implants or flaps to achieve tension-free closure and successful wound healing. Use of these techniques allows wound closure and good cosmetic results for even those wounds that initially may seem foreboding.  相似文献   

12.
OBJECTIVE: To determine if CO(2) laser was superior to conventional surgical techniques (CST) for creation of skin flaps in dogs as determined by hemostasis, wound healing, and wound tensile strength. STUDY DESIGN: In-vivo model ANIMALS: Six large, mixed-breed dogs. METHODS: On each dog's trunk, 3 pairs of identical, dorsally based, pedicled skin flaps were created and sutured back into position. Based on a Latin Square design, flaps on one side were created with a CO(2) laser and on the other side by CST. Intraoperative hemorrhage was measured by weighing sponges used to absorb blood. On days 7, 10, and 14, specimens from the flap-skin junction and the central portion of each pair of flaps were collected. Specimens were subjected to tensile strength testing and histologic examination to evaluate wound healing. RESULTS: Mean (+/- standard error of mean [SEM]) hemorrhage was significantly less (P =.02) with CO(2) laser (4.70 +/- 1.37 g) than CST (10.82 +/- 1.37 g). Wound tensile strength (N/m(2)) after CST (0.49 +/- 0.049) was significantly greater (P =.01) than with CO(2) laser (0.17 +/- 0.049). Laser incisions had partial necrosis of the wound edges and a more extensive inflammatory response; however, healing of the wound beds were similar regardless of technique. CONCLUSIONS: The CO(2) laser provided better intraoperative hemostasis than CST. However, overall healing and increase in tensile strength of the skin-flap junction of the flaps created by the laser may be delayed during the first few weeks of wound healing. CLINICAL RELEVANCE: Skin flaps used to repair large skin defects in dogs can be created and elevated with a CO(2) laser. In areas of increased skin mobility or tension, skin flaps created with CO(2) laser may be more susceptible to complications such as dehiscence, and care should be taken to minimize these complications.  相似文献   

13.
This report describes a case of osteoma cutis diagnosed by physical examination, surgery and histopathological examination. A 2‐year‐old Thoroughbred colt with hindlimb lameness was brought to our facility. Physical examination showed a well‐circumscribed, large plate‐like mass covered with normal haired skin in the right thigh region. Ultrasonography revealed a subcutaneous linear mass. After surgical removal, histopathological examination showed thin mature bone surrounded by fibrocollagenous tissues. To the authors' knowledge, this is the first report of spontaneous idiopathic osteoma cutis in horses.  相似文献   

14.
Our objective was to evaluate the effectiveness of skin-stretching devices for closing defects on the extremities of dogs. Antebrachial skin defects were created on the limbs of 24 dogs randomly divided into three groups. Skin stretchers included staples and sutures passing through them (group A), sutures and hypodermic needles (group B), and Pavletic device (group C). Wounds on the left were further undermined in all groups. Tension and blood perfusion were assessed. After removing the stretchers on day 3, the defects were sutured and wound healing was clinically scored. Histological variables evaluated were cellular infiltration, edema, collagen orientation, and thickness of epidermis. Significant differences in tension were found among groups (p < 0.0005) and between measurement times for undermined (p = 0.001) or non-undermined (p < 0.0005) wounds. In contrast, blood perfusion values did not differ significantly. Clinical scores for group B seemed to be better than those for groups A and C, but differences were not significant. Primary wound closure using the Pavletic device was not feasible. No significant differences in histological variables were found between groups. Skin stretching with staples or hypodermic needles resulted in successful wound management with minor side effects on skin histology and circulation.  相似文献   

15.
The purpose of this study was to compare postoperative wound healing in canine ovariohysterectomy following the use of an absorbable monofilament poliglecaprone 25 suture in 2 different skin closure techniques, the buried continuous subcuticular (BCS) suture pattern and the simple interrupted (SI) suture pattern. These 2 skin closure techniques were evaluated against a nonabsorbable polypropylene monofilament suture in an SI pattern. Wounds were assessed by using a semiquantitative scoring system at 18 to 24 hours and 10 to 14 days, postoperatively. Results indicated that the BCS closure using poliglecaprone 25 demonstrated a higher rate of tissue reactivity initially (18-24 hours postoperatively), as compared with the SI closure using either suture material. By 10 to 14 days postoperatively, poliglecaprone 25 used in a BCS closure was associated with significantly lower wound scores than was the same material used in an SI closure. It was concluded that the BCS closure may effect a better cosmetic appearance to the skin closure in a canine ovariohysterectomy at the time of the recheck appointment. Furthermore, by obviating the need for suture removal, use of the BCS pattern may eliminate the requirement for this return appointment.  相似文献   

16.
A 13-year-old neutered male miniature dachshund suffered ~30% total skin loss following an attack by another dog. After numerous failed attempts at wound management and closure, the wound was successfully healed by epithelialization using tilapia skin grafts. At each tilapia skin graft placement, the wound bed appeared pink, clean, and healthy with excellent progression of epithelialization at all edges. With use of the tilapia grafts, epithelialization occurred at a rate of 1.76 mm/day. As a result, the wound reached complete closure by epithelialization with no evidence of wound contracture in 102 days.Key clinical message:Tilapia skin grafts were successfully used for management of a large bite wound in a dog and may promote accelerated epithelialization in full thickness skin wounds.  相似文献   

17.
This report describes the successful management of peristomal tissue necrosis following prepubic urethrostomy in a cat. The novel technique of temporary urethral ligation was used in combination with temporary tube cystostomy and vacuum assisted closure to allow for wound management prior to performing wound closure by utilization of a flank fold skin flap then definitive prepubic urethrostomy. Eleven month follow-up indicated excellent outcome with the cat having returned to normal behaviour apart from having adapted its posture to urinate.  相似文献   

18.
OBJECTIVE: To examine the effect of partial arytenoidectomy without mucosal closure on postoperative racing performance and long-term complications in Thoroughbred racehorses treated for laryngeal hemiplegia, arytenoid chondropathy, or failed laryngoplasty. STUDY DESIGN: Retrospective study. ANIMALS: Twenty-seven Thoroughbred racehorses. METHODS: Medical records of Thoroughbred racehorses that had partial arytenoidectomy without mucosal closure between 1992 and 2002 were reviewed. Horses were divided into groups: horses that had not raced (Group 1) and those that had raced (Group 2) before surgery. Lifetime race records were compared between groups. A standard starts index (SSI) and performance index (PI) were used for Groups 1 and 2, respectively, to objectively evaluate each horse's postoperative performance. Telephone interviews of owners and trainers were used for subjective performance evaluation and to determine prevalence of long-term complications. RESULTS: Eleven (61%) Group 1 and 7 (78%) Group 2 horses raced and earned money after surgery. All Group 1 horses that raced performed at a level lower than the national average. Only 1 Group 2 horse had an improved PI score postoperatively. CONCLUSIONS: Thoroughbred racehorses have a fair prognosis for racing successfully after partial arytenoidectomy without mucosal closure. CLINICAL RELEVANCE: This technique may be a practical alternative to primary mucosal closure, would decrease surgical time, and avoid some problems reported with primary mucosal closure.  相似文献   

19.
This study evaluates the cranial rectus abdominus muscle pedicle flap as the sole blood supply for the caudal superficial epigastric skin flap. This flap was composed of a cranially based rectus abdominus muscle pedicle flap that was attached to the caudal superficial epigastric island skin flap (including mammary glands 2 to 5) via the pudendoepigastric trunk. Selective angiography of the cranial epigastric artery in eight cadaver dogs proved that the arterial vasculature in the cranial rectus abdominus was contiguous with that in the caudal superficial epigastric skin flap. In the live dog study, three of six of the flaps failed because of venous insufficiency. Necrosis of mammary gland 2 occurred in two of six flaps. One of six flaps survived with the exception of the cranial most aspect of mammary gland 2. Angiography of the cranial epigastric artery proved that arterial blood supply to these flaps was intact. Histological evaluation of the failed flaps showed full-thickness necrosis of the skin and subcutaneous tissues, the presence of severe congestion, and venous thrombosis. Retrograde venous blood flow through the flap was inconsistent, and hence resulted in failure of this myocutaneous flap. Use of this flap for clinical wound reconstruction cannot be recommended.  相似文献   

20.
OBJECTIVE: To evaluate the primary critical ischemia time for the deep circumflex iliac (DCI) cutaneous flap in cats. STUDY DESIGN: In vivo model. ANIMALS: Thirteen young adult female cats. METHODS: An island skin flap was created on the right side of each cat based on the angiosome of the ventral branches of the DCI vessels. The cats were randomly assigned to a flap ischemia time ranging from 1 to 3 hours in 10-minute intervals. Microvascular clamps were used to occlude the artery and vein for the designated time. Flaps were sutured into position after the ischemic period. On day 3, fluorescein dye was administered and the flaps were evaluated under ultraviolet light to assess percent area of perfusion. On days 7 and 14, the percent area of survival was determined for each flap based on cutaneous morphometry. RESULTS: All flaps had 100 percent area of survival throughout the study. On day 3, all flaps fluoresced uniformly compared with the surrounding skin. On days 7 and 14, all flaps were uniformly viable as confirmed by skin color, consistency, bleeding, and hair re-growth. CONCLUSION: The DCI cutaneous flap in cats can withstand up to 3 hours of ischemia with predictable survival. CLINICAL RELEVANCE: In a clinical setting, high success rates can be expected with microvascular transfer of the DCI cutaneous flap in cats when the ischemia time is <3 hours and precise surgical technique is used.  相似文献   

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