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Logothetou V, L'Eplattenier H, Shimizu N. Complications and influence of cutaneous closure technique on subdermal plexus flaps in 97 dogs (2006-2022). Vet Surg 2024; 53:546-555. [PMID: 38037259 DOI: 10.1111/vsu.14051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 10/17/2023] [Accepted: 11/09/2023] [Indexed: 12/02/2023]
Abstract
OBJECTIVE To determine the incidence and severity of complications for subdermal plexus flaps in dogs and compare the complications when using sutures or staples for cutaneous closure of subdermal plexus flaps. STUDY DESIGN Retrospective monocentric study. SAMPLE POPULATION Ninety-seven client-owned dogs. METHODS Dogs that underwent wound reconstruction using subdermal plexus flaps were retrospectively identified. Type of flap, cutaneous closure technique, complications and level of complication associated with their use were recorded. Follow-up was considered adequate if it was more than 10 days postoperatively or until a complication occurred. RESULTS Complications were seen in 52 dogs (53.6%), of which 13/18 (72.2%) of dogs had cutaneous closure with skin staples versus 39/79 (49.3%) with skin sutures. The location of the mass/wound on the head and use of an advancement flap was associated with lower incidence of complications (p < .001; p = .018 respectively). Location of the mass/wound on the proximal pelvic limb was associated with a low level of complications (p = .01) on univariable analysis only. On multivariable analysis, only an increased bodyweight was associated with an increased incidence of complications (p = .029). CONCLUSIONS Increased weight may be associated with an increased risk of complications with subdermal plexus flaps. No risk factor was found to be associated with the severity of complications. CLINICAL SIGNIFICANCE Overall incidence of complications for subdermal plexus flaps in dogs in this study was 53.6%. The number of dogs included in the study was not sufficient to assess if the skin closure technique affects the incidence of complications.
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Thompson JL, Miller L, Bowlt Blacklock K. Effects of cyanoacrylate on leakage pressures of cooled canine cadaveric jejunal enterotomies. Vet Surg 2024; 53:367-375. [PMID: 38071682 DOI: 10.1111/vsu.14059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 10/31/2023] [Accepted: 11/24/2023] [Indexed: 02/16/2024]
Abstract
OBJECTIVE To compare the intraluminal initial and maximal pressures of enterotomies closed using three different techniques (single-layer appositional continuous closure; closure with cyanoacrylate; a single-layer appositional closure augmented with cyanoacrylate) in a cooled canine cadaveric jejunal model and to report the initial leak location in all samples. STUDY DESIGN Experimental, ex-vivo study. SAMPLE POPULATION Grossly normal chilled small intestine segments from three canine cadavers. METHODS A total of 45 chilled jejunal segments (n = 15 segments/group) were assigned to a handsewn group (HSE), a cyanoacrylate only group (CE) and a handsewn and cyanoacrylate group (HS + CE). A 2 cm antimesenteric enterotomy was performed and closure with one of the above techniques. Initial leakage pressures (ILP), maximal intraluminal pressures (MIP) and initial leakage location were recorded by a single observer. RESULTS Handsewn enterotomies leaked at higher ILP when augmented with cyanoacrylate (83.3 ± 4.6 mmHg, p < .001) compared to both the HSE group (43.8 ± 5.3 mmHg) and the CE group (18.6 ± 3.5 mmHg). Those sealed with cyanoacrylate only leaked at a lower MIP compared with the other groups (p < .001). Maximal intraluminal pressures did not differ between handsewn enterotomies, whether augmented or not (p = .19). CONCLUSION Reinforcement of a sutured enterotomy closure with cyanoacrylate was easy to perform and resulted in significantly increased initial leak pressures in cadaveric jejunum. CLINICAL SIGNIFICANCE The increased leakage pressures achieved by reinforcing enterotomies with cyanoacrylate could consequently reduce the incidence of postoperative intestinal leakage following an enterotomy and may result in reduced patient morbidity or mortality.
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Affiliation(s)
- Jamie-Leigh Thompson
- Department of Small Animal Surgery, The Royal Dick School of Veterinary Studies, Edinburgh, Scotland
| | - Lucy Miller
- Department of Anesthesia and Analgesia, The Royal Dick School of Veterinary Studies, Edinburgh, Scotland
| | - Kelly Bowlt Blacklock
- Department of Small Animal Surgery, The Royal Dick School of Veterinary Studies, Edinburgh, Scotland
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Villagomez A, Borja T, Pontón P, Segnini G, Barba P, Chiliquinga A, Yamberla I, Pupiales C, Suquillo D, Díaz RF, Cabrera F, Caicedo A. Histological and microbiological evaluation of surgical wound closure in mouse skin with cyanoacrylate (Histoacryl®) in comparison to poliglecaprone (Monocryl®) traditional suture. Vet Anim Sci 2021; 13:100180. [PMID: 34141950 PMCID: PMC8188065 DOI: 10.1016/j.vas.2021.100180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 05/21/2021] [Accepted: 05/23/2021] [Indexed: 11/13/2022] Open
Abstract
Incisional wound closure is a critical surgical step to facilitate tissue healing. Cyanoacrylates (Histoacryl®) have become a popular veterinary wound closure practice. Effects of Histoacryl® over traditional suture on wounds rest undetermined. Histoacryl® vs. Poliglecaprone (Monocryl®) have similar regenerative results in mice. Histoacryl® or Monocryl® could be used to treat wounds in rodents.
Incisional wound closure is a key surgical step to facilitate tissue healing, reduce the risk of infection and obtain esthetic and functional recovery. Cyanoacrylates such as Histoacryl® have become a popular choice in surgical veterinary practice. However, how Histoacryl® is affecting tissue regeneration and bacterial load in the wound in comparison to poliglecaprone (Monocryl®) traditional suture methods remains to be determined. This work aimed to evaluate how wounded tissue responds to traditional suture with Monocryl® (poliglecaprone 25/4-0) and Histoacryl®, as well as provide evidence of their effects on wound healing in mice. Fortyeight hours after the incisional procedure, wound tissue biopsies were prepared for histological and microbiological analysis. Biopsies were fixed and colored with Mallory's trichrome and hematoxylin-eosin stains. For microbiological assays, biopsies were suspended in tryptic soy broth (TSB) and 1/10 diluted to evaluate the number of CFU in nutrient agar plates. Our results show no differences between Histoacryl® and Monocryl® traditional suture suggesting that both methods could be used to treat wounds in small animals such as rodents.
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Affiliation(s)
- A Villagomez
- Escuela de Medicina Veterinaria, Universidad San Francisco de Quito USFQ, Quito, Ecuador.,Servicio de Cirugía de Alta Complejidad y Mínima invasión - Hospital Docente de Especialidades Veterinarias, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| | - T Borja
- Servicio de Patología, Hospital Voz Andes, Quito, Ecuador
| | - P Pontón
- Servicio de Patología, Hospital Voz Andes, Quito, Ecuador
| | - G Segnini
- Escuela de Medicina Veterinaria, Universidad San Francisco de Quito USFQ, Quito, Ecuador.,Servicio de Cirugía de Alta Complejidad y Mínima invasión - Hospital Docente de Especialidades Veterinarias, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| | - P Barba
- Carrera de Biotecnología, Universidad Técnica del Norte, Ibarra, Ecuador
| | - A Chiliquinga
- Carrera de Biotecnología, Universidad Técnica del Norte, Ibarra, Ecuador
| | - I Yamberla
- Carrera de Biotecnología, Universidad Técnica del Norte, Ibarra, Ecuador
| | - C Pupiales
- Carrera de Biotecnología, Universidad Técnica del Norte, Ibarra, Ecuador
| | - D Suquillo
- Ingeniería en Procesos Biotecnológicos, Colegio de Ciencias Biológicas y Ambientales COCIBA, Universidad San Francisco de Quito USFQ, Quito, Ecuador.,Instituto de Investigaciones en Biomedicina iBioMed, Universidad San Francisco de Quito USFQ, Quito, Ecuador.,Mito-Act Research Consortium, Quito, Ecuador
| | - R F Díaz
- Escuela de Medicina Veterinaria, Universidad San Francisco de Quito USFQ, Quito, Ecuador.,Instituto de Investigaciones en Biomedicina iBioMed, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| | - F Cabrera
- Escuela de Medicina Veterinaria, Universidad San Francisco de Quito USFQ, Quito, Ecuador.,Instituto de Investigaciones en Biomedicina iBioMed, Universidad San Francisco de Quito USFQ, Quito, Ecuador.,Mito-Act Research Consortium, Quito, Ecuador
| | - A Caicedo
- Instituto de Investigaciones en Biomedicina iBioMed, Universidad San Francisco de Quito USFQ, Quito, Ecuador.,Mito-Act Research Consortium, Quito, Ecuador.,Escuela de Medicina, Universidad San Francisco de Quito USFQ, Quito, Ecuador.,Sistemas Médicos SIME, Universidad San Francisco de Quito USFQ, Quito, Ecuador
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Jones CA, Lipscomb VJ. Indications, complications, and outcomes associated with subdermal plexus skin flap procedures in dogs and cats: 92 cases (2000-2017). J Am Vet Med Assoc 2020; 255:933-938. [PMID: 31573867 DOI: 10.2460/javma.255.8.933] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To describe indications, complications, and outcomes associated with subdermal plexus skin flap (SPSF) procedures in dogs and cats. ANIMALS 53 dogs and 20 cats that received SPSFs for reconstruction of skin defects from 2000 to 2017. PROCEDURES Medical record data were collected and summarized regarding patient signalment, indication for the SPSF procedure, type and location of SPSF, complications, and outcome. RESULTS 92 SPSF procedures (64 in dogs and 28 in cats) were included. Indications for the procedures included tumor excision (n = 37 [40%]), acute wound (14 [15%]) or chronic wound (28 [30%]) reconstruction, surgical scar revision (7 [8%]), and other reasons (6 [7%]). Types of SPSFs included advancement (31 [34%]), axillary fold (20 [22%]), inguinal fold (20 [22%]), rotation (16 [17%]), transposition (3 [3%]), and distant direct (2 [2%]). Complications were noted for 47 (51%) procedures at a mean ± SD of 6.9 ± 4.0 days after surgery and were classified as minor (34 [37%]) or major (13 [14%]). Outcome was considered excellent for 44 (48%) procedures, good for 33 (36%), fair for 13 (14%), and poor for 2 (2%). CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that approximately half of SPSF procedures in dogs and cats can be expected to be followed by a complication, occurring at a mean of 1 week after surgery, and yet with appropriate management of these complications, a good to excellent outcome was possible. Owners should be counseled about the likely need for additional visits and costs associated with treatment of postoperative complications.
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Zhang G, Langova V, Havlicek M. Nasal planum reconstruction after tumour resection using a lip-to-nose flap in a dog. J Small Anim Pract 2018; 61:648-652. [PMID: 30488435 DOI: 10.1111/jsap.12960] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Revised: 06/21/2018] [Accepted: 06/26/2018] [Indexed: 11/29/2022]
Abstract
Here we describe the use of a novel lip-to-nose flap technique for nasal planum reconstruction after tumour removal in a dog. A mast cell tumour involving the nasal planum was first resected by removing the roof and the wing of the left nasal vestibule. An interpolation subdermal plexus flap was derived from the left caudal lip with vascular contribution from the lateral nasal artery. This lip-to-nose flap was rotated into the defect via a bridging incision. The mucocutaneous junction of the lip was used to emulate the keratinised nasal planum and the buccal mucosa was sutured to be congruent with the mucosa of the vestibule. This resulted in the lip-to-nose flap successfully closing the surgical defect and giving an aesthetic appearance similar to the original nasal planum.
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Affiliation(s)
- G Zhang
- Department of Surgery and Oncology, Small Animal Specialist Hospital, North Ryde, New South Wales, 1670, Australia
| | - V Langova
- Department of Surgery and Oncology, Small Animal Specialist Hospital, North Ryde, New South Wales, 1670, Australia
| | - M Havlicek
- Department of Surgery and Oncology, Small Animal Specialist Hospital, North Ryde, New South Wales, 1670, Australia
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Thomson AE, Soukup JW. Composite Resection of Tumors of the Rostral Maxilla and Dorsolateral Muzzle Utilizing an Upper Lip-Sparing, Combined Approach in Dogs. Front Vet Sci 2018; 5:54. [PMID: 29616231 PMCID: PMC5869250 DOI: 10.3389/fvets.2018.00054] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Accepted: 03/05/2018] [Indexed: 11/13/2022] Open
Abstract
Tumors of the rostral maxilla that involve both the oral mucosa and the dermis or subdermis of the dorsolateral muzzle provide unique challenges for the oromaxillofacial surgeon. Traditionally described approaches to such lesions may involve an intraoral incision that extends and involves the upper lip to envelope the involved dermis of the dorsolateral muzzle. However, such an approach unnecessarily resects upper lip tissue resulting in a large defect that likely requires advanced skin flaps or grafts for reconstruction. Such flaps are technically challenging and introduce potential for significance postoperative complications. In this article, we provide a detailed description a combined intra- and extraoral approach that allows for composite resection of tumors of the rostral maxilla that also involve the dorsolateral muzzle. The described technique allows for excellent intraoperative visualization and provides a superior cosmetic outcome that minimizes postoperative complications. In addition, we describe our experience utilizing the technique in three clinical cases.
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Affiliation(s)
- Amy E Thomson
- Dentistry and Oral Surgery, Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI, United States
| | - Jason W Soukup
- Dentistry and Oral Surgery, Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI, United States
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Cuddy LC. Wound Closure, Tension-Relieving Techniques, and Local Flaps. Vet Clin North Am Small Anim Pract 2017; 47:1221-1235. [PMID: 28807399 DOI: 10.1016/j.cvsm.2017.06.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Wounds are often addressed by primary or delayed primary closure. Although many skin wounds could go on to heal by second intention, this results in a less cosmetic outcome, takes longer, and in the long run, is often more expensive. As a general rule, the simplest method of wound closure that is likely to succeed should be chosen. If tension is present at the wound edges, wound dehiscence is likely to occur. Using specific techniques to relieve tension on wound edges and recruiting local flaps from neighboring regions are useful ways to achieve wound closure.
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Affiliation(s)
- Laura C Cuddy
- Vets Now 24/7 Emergency and Specialty Hospital, 98 Bury Old Road, Whitefield, Manchester M45 6TQ, UK; Veterinary Specialists, Clonmahon, Summerhill, County Meath A83 KR62, Ireland.
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8
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Losinski SL, Stanley BJ, Schallberger SP, Nelson LL, Millard HAT. Versatility of the Angularis Oris Axial Pattern Flap for Facial Reconstruction. Vet Surg 2015; 44:930-8. [DOI: 10.1111/vsu.12408] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Sara L. Losinski
- Department of Small Animal Clinical Sciences; Michigan State University; East Lansing Michigan
| | - Bryden J. Stanley
- Department of Small Animal Clinical Sciences; Michigan State University; East Lansing Michigan
| | - Sandra P. Schallberger
- Department of Small Animal Clinical Sciences; College of Veterinary Medicine; University of Florida; Gainesville Florida
| | - Laura L. Nelson
- Department of Small Animal Clinical Sciences; Michigan State University; East Lansing Michigan
| | - Heather A.M. Towle Millard
- Department of Veterinary Clinical Sciences; College of Veterinary Medicine; Purdue University; West Lafayette Indiana
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Aristizabal FA, Lopes MA, Silva A, Avanza MF, Nieto JE. Evaluation of the Effect of Onlay Mesenteric Flaps on End-To-End Jejunojejunostomy Healing in Horses. Vet Surg 2014; 43:479-86. [DOI: 10.1111/j.1532-950x.2014.12120.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2012] [Accepted: 11/29/2013] [Indexed: 11/28/2022]
Affiliation(s)
- Fabio A. Aristizabal
- Departamento de Médicina Veterinária; Universidade Federal de Viçosa; Viçosa MG Brazil
| | - Marco Aurélio Lopes
- Departamento de Médicina Veterinária; Universidade Federal de Viçosa; Viçosa MG Brazil
| | - Adriana Silva
- Departamento de Médicina Veterinária; Universidade Federal de Viçosa; Viçosa MG Brazil
| | | | - Jorge E. Nieto
- Department of Surgical and Radiological Sciences; School of Veterinary Medicine University of California-Davis; Davis California
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