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Eiger SN, Bertran J, Reynolds PS, Regier P, Case JB, Ham K, Mison M, Fox-Alvarez WA. Use of near-infrared fluorescence angiography with indocyanine green to evaluate direct cutaneous arteries used for canine axial pattern flaps. Vet Surg 2024; 53:1073-1082. [PMID: 38837285 DOI: 10.1111/vsu.14121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 05/06/2024] [Accepted: 05/19/2024] [Indexed: 06/07/2024]
Abstract
OBJECTIVE To describe the use of near-infrared angiography (NIRFA) to identify the vascularization of three canine axial pattern flaps (APFs) omocervical (OMO), thoracodorsal (THO), and caudal superficial epigastric (CSE); to establish a vascular fluorescence pattern (VFP) grading system; and to evaluate the effect of NIRFA on surgeon flap dimension planning compared to traditional landmark palpation (LP) and visualization assessments. STUDY DESIGN Experimental study. ANIMALS A total of 15 healthy, client-owned dogs. METHODS Dogs were sedated and flap sites were clipped. LP-based margins were drawn and preinjection images were recorded. Indocyanine green (ICG) was administered and VFP images were recorded. VFP scores were determined by five surgeons. Margin alterations were performed based on NIRFA-ICG images. Altered measurements were compared between LP and NIRFA-ICG images. RESULTS Vascularization of the CSE flap was most visible with NIRFA with VFP scores 4/4 for 13/15 dogs. Intersurgeon agreement for VFP grades was poorest for THO (ICC = 0.35) and intermediate for OMO (ICC = 0.49) flaps. Surgeons were more likely to adjust dimensions for CSE flaps relative to OMO (OR 17.3, 95% CI: 6.2, 47.8) or THO (25.5; 8.6, 75.7). CONCLUSION Using a grading system, we demonstrated that the CSE flap was most visible. Surgeons were more likely to adjust the LP-CSE flap margins based on fluorescence patterns and were more likely to rely on LP when visualization scores were low. CLINICAL SIGNIFICANCE NIRFA has possible applications identifying some direct cutaneous arteries of APFs and their associated angiosomes in real-time. Further investigation is indicated to study NIRFA's potential to improve patient specific APF planning.
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Affiliation(s)
- Sophie N Eiger
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA
| | - Judit Bertran
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA
| | - Penny S Reynolds
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA
- Department of Anesthesiology, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Penny Regier
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA
| | - J Brad Case
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA
| | - Kathleen Ham
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA
| | - Michael Mison
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA
| | - W Alexander Fox-Alvarez
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA
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Marchegiani A, Troisi A, Bazzano M, Spaterna A, Fruganti A. A Prospective, Blinded, Open-Label Clinical Trial to Assess the Ability of Fluorescent Light Energy to Enhance Wound Healing after Mastectomy in Female Dogs. Animals (Basel) 2024; 14:1250. [PMID: 38672398 PMCID: PMC11047670 DOI: 10.3390/ani14081250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 04/18/2024] [Accepted: 04/22/2024] [Indexed: 04/28/2024] Open
Abstract
Mammary gland tumors represent the most frequently diagnosed malignant neoplasm in intact female dogs, and surgical removal represents the current gold standard treatment. To promote wound healing and prevent possible bacterial contamination, perioperative antimicrobials are commonly used in clinical practice, even though there are no publications establishing guidelines for the use of such drugs in canine mastectomy. The aim of the present study was to evaluate the ameliorative effect of fluorescent light energy on the quality of the healing process after mastectomy surgery in female dogs, in the absence of perioperative antimicrobial administration. Nine female dogs received a multiple-gland mastectomy due to gland tumors and received FLE application immediately after surgery and then five days after. The surgical incisions were evaluated by a blind investigator over time using the Modified Hollander Cosmesis and Modified Draize Wound Healing Score systems. Statistical analysis revealed a significant ameliorative effect of FLE in the control of step-off borders, contour irregularities, and excessive distortion. In addition, erythema, edema, and serous discharge were lower for those wounds managed with FLE. These results underscore the advantageous impact of FLE on the healing of post-mastectomy wounds in female dogs, offering the dual benefits of reducing potential infection risks and lessening the home care burden for pet owners.
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Affiliation(s)
| | | | - Marilena Bazzano
- School of Biosciences and Veterinary Medicine, University of Camerino, 62032 Camerino, Italy; (A.M.); (A.T.); (A.S.); (A.F.)
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Grings GF, Surita LE, Nicknich D, Torikachvili M, Dos Santos EAR, Wartchow B, Portinho CP, Gomes C, Alievi MM. Reconstruction of large scalp defect in a brown howler monkey (Alouatta guariba clamitans): A case report. J Med Primatol 2024; 53:e12696. [PMID: 38509029 DOI: 10.1111/jmp.12696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 02/22/2024] [Indexed: 03/22/2024]
Abstract
This case report describes different repair techniques used to reconstruct a large scalp defect in a brown howler monkey (Alouatta guariba clamitans) hit by a vehicle. Three reconstructive procedures were performed in two surgical stages. The repair techniques had successful outcomes on the patient's rehabilitation.
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Affiliation(s)
- Germano Filipe Grings
- Veterinary Clinics Hospital, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Lívia Eichenberg Surita
- Center for Rehabilitation and Conservation of Wild Animals (PRESERVAS), Faculty of Veterinary Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Daniela Nicknich
- Center for Rehabilitation and Conservation of Wild Animals (PRESERVAS), Faculty of Veterinary Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Marcela Torikachvili
- Veterinary Clinics Hospital, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Eduardo Almeida Ruivo Dos Santos
- Center for Rehabilitation and Conservation of Wild Animals (PRESERVAS), Faculty of Veterinary Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Barbara Wartchow
- Center for Rehabilitation and Conservation of Wild Animals (PRESERVAS), Faculty of Veterinary Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Ciro Paz Portinho
- Plastic Surgery Division, Porto Alegre Clinics Hospital (HCPA), Porto Alegre, Rio Grande do Sul, Brazil
| | - Cristiano Gomes
- Department of Veterinary Medicine, Faculty of Veterinary Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Marcelo Meller Alievi
- Center for Rehabilitation and Conservation of Wild Animals (PRESERVAS), Faculty of Veterinary Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- Department of Veterinary Medicine, Faculty of Veterinary Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
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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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Gaudio E, Aertsens A, Field E, Hattersley R, Baines S. Short-term outcome and complications following cutaneous reconstruction using cranial superficial epigastric axial pattern flaps in dogs: six cases (2008-2022). J Small Anim Pract 2023; 64:704-709. [PMID: 37555359 DOI: 10.1111/jsap.13657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 05/15/2023] [Accepted: 06/10/2023] [Indexed: 08/10/2023]
Abstract
OBJECTIVES To investigate short-term outcome and complications following the use of the cranial superficial epigastric axial pattern flap to reconstruct cutaneous defects in dogs. MATERIALS AND METHODS Medical records from dogs undergoing reconstructive surgery between 2008 and 2022 by means of cranial superficial epigastric axial pattern flap were reviewed. Data on signalment, reason for reconstruction, defect size, flap healing, post-operative complications and need for revision surgery were collected. RESULTS Six dogs were included in the study. Indications for reconstruction included neoplasia (4/6), skin necrosis due to vehicular trauma (1/6) and dog bite (1/6). Postoperative complications occurred in 50% of the patients and included seroma (1/6), bruising (2/6) and necrosis of the distal portion of the flap (2/6), with two dogs developing concurrent complications. One dog required open wound management and additional surgery. Overall outcome was scored excellent in three, good in two, and fair in one dog. CLINICAL SIGNIFICANCE Despite the relatively high complication rate, most of the complications were deemed minor and could be managed conservatively. Eventually, all wounds healed completely and only one flap required revision surgery.
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Affiliation(s)
- E Gaudio
- Willows Veterinary Centre & Referral Service, Highlands Road, Shirley, Solihull, B90 4NH, UK
| | - A Aertsens
- Iowa State University, College of Veterinary Medicine, 1800 Christensen Drive, Ames, Iowa, 50011-1134, USA
| | - E Field
- Highcroft Veterinary Referrals, 615 Wells Road, Whitchurch, Bristol, BS14 9BE, UK
| | - R Hattersley
- Dick White Referrals, London Road, Cambridgeshire, CB8 0UH, UK
| | - S Baines
- Willows Veterinary Centre & Referral Service, Highlands Road, Shirley, Solihull, B90 4NH, UK
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Angelou V, Psalla D, Kazakos G, Marouda C, Chatzimisios K, Kyrana Z, Karayannopoulou M, Papazoglou L. Evaluation of Survival of Subdermal Plexus Skin Flaps in 8 Cats After Injection of Platelet Rich Plasma. Top Companion Anim Med 2023; 53-54:100770. [PMID: 36813229 DOI: 10.1016/j.tcam.2023.100770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Revised: 11/24/2022] [Accepted: 02/14/2023] [Indexed: 02/23/2023]
Abstract
The aim of the present study was to evaluate the effect of platelet-rich plasma injection on the survival of experimentally developed subdermal plexus skin flaps in cats. Two flaps, 2 cm wide and 6 cm long were created bilaterally in the dorsal midline in 8 cats. Each flap was randomized to 1 of 2 groups: platelet-rich plasma injection and control. After flap development, the flaps were immediately placed back on the recipient bed. Then 1.8 mL of platelet-rich plasma was equally injected into 6 different parts of the treatment flap. All flaps were evaluated macroscopically daily and on days 0, 7, 14, and 25 by planimetry, Laser Doppler flowmetry, and histology. Mean flap survival on day 14 was 80.437 % (±22.745) for the treatment group and 66.516 % (±24,12) for the control group with no statistically significant difference between the 2 groups (P = .158). Histologically, a significant difference was found between the base of the PRP and the control flap in edema score on day 25 (P = .034). In conclusion, there is no evidence to support the use of platelet-rich plasma in subdermal plexus flaps in cats. However, the use of platelet-rich plasma may aid in reducing edema of subdermal plexus flaps.
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Affiliation(s)
- Vasileia Angelou
- Unit of Obstetrics and Surgery, Companion Animal Clinic, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.
| | - Dimitra Psalla
- Laboratory of Pathology, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - George Kazakos
- Unit of Anaesthesiology and Intensive Care, Companion Animal Clinic, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Christina Marouda
- Laboratory of Pathology, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Kyriakos Chatzimisios
- Unit of Obstetrics and Surgery, Companion Animal Clinic, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Zacharenia Kyrana
- Department of Agriculture, Faculty of Agriculture, Forestry and Natural Environment, Aristotle University of Thessaloniki, Thessaloniki, Greeece
| | - Maria Karayannopoulou
- Unit of Obstetrics and Surgery, Companion Animal Clinic, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Lysimachos Papazoglou
- Unit of Obstetrics and Surgery, Companion Animal Clinic, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Brand KJ, Malek S, Ruple A, Hendrix GK. Evaluation of Surgical Gown Cuff Contamination During Orthopaedic Surgery in a Veterinary Teaching Hospital. Vet Comp Orthop Traumatol 2023; 36:21-28. [PMID: 36150696 DOI: 10.1055/s-0042-1756621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
OBJECTIVE The objective of this study was to determine the frequency of positive cultures of the surgical gown cuffs among scrubbed personnel prior to and immediately after orthopaedic surgical procedures performed on client-owned dogs. STUDY DESIGN In this cross-sectional study, the left and right surgical gown cuffs of three scrubbed persons in 10 orthopaedic surgical procedures were individually sampled using a sterile wipe prior to and immediately after surgery in order to determine the frequency of and risk factors associated with positive bacterial cultures. RESULTS Fifty of 120 (41.6%) cultures were positive with an even distribution before and after surgery. The three most common genera were Staphylococcus, Corynebacterium and Streptococcus. Using multivariable logistic regression models, humidity in the operating room (odds ratio: 1.04, 95% confidence interval: 1.00-1.08; p = 0.038) and the number of individuals scrubbed into surgery (odds ratio: 0.59, 95% confidence interval: 0.39-0.91; p = 0.016) had a significant effect on the likelihood of positive culture after surgery. Of the nine patients available for follow-up, one dog developed osteomyelitis. CONCLUSIONS Maintaining the humidity in the operating room to the lowest comfortable level may reduce contamination of the surgical gown cuffs. Confirmation of bacterial contamination of surgical gown cuffs warrants adherence to operative guidelines to minimize the risk of surgical gown cuffs' contact with sterile attire, equipment and the surgical field during surgical procedures.
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Affiliation(s)
- Kenneth J Brand
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, Indiana, United States
| | - Sarah Malek
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, Indiana, United States
| | - Audrey Ruple
- Department of Public Health, College of Health and Human Sciences, Purdue University, West Lafayette, Indiana, United States
| | - G Kenitra Hendrix
- Indiana Animal Disease Diagnostic Laboratory, West Lafayette, Indiana, United States
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Kermanian CS, Buote NJ, Bergman PJ. Medicinal Leech Therapy in Veterinary Medicine: A Retrospective Study. J Am Anim Hosp Assoc 2022; 58:303-308. [PMID: 36315858 DOI: 10.5326/jaaha-ms-7146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2021] [Indexed: 06/16/2023]
Abstract
The objective of this study was to report the clinical indications, outcomes, and complications associated with medicinal leech therapy (MLT) in dogs and cats. Medical records (2012-2016) of client-owned dogs (n = 9) and cats (n = 3) treated with MLT at one institution were retrospectively reviewed. Retrieved data included the signalment, indications, physical examination findings, laboratory results, methods of leeching, outcomes, and complications associated with MLT. Following MLT sessions, nine patients (75%) visibly showed clear improvement of the affected tissue. One patient (8%) was euthanized before complete healing owing to pulmonary parenchymal disease. Improvement or appearance of tissue following MLT was not recorded in two patients (17%). Results suggest that MLT may be a safe and effective treatment modality for venous congestion and necrosis in compromised skin flaps and wounds with success in resolving 75% of the lesions in this study. This study is suggestive of the value of MLT when more conventional treatment methods fail in dogs and cats. A data collection form was created for veterinarians to use with the goal of obtaining standardized, objective MLT data for future studies.
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Affiliation(s)
- Celine S Kermanian
- From Small Animal Surgery, The Animal Medical Center, New York, New York (C.S.K.)
| | - Nicole J Buote
- VCA West Los Angeles Animal Hospital, Los Angeles, California (N.J.B.)
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Michalik D, Nolff MC. Case Report: Indocyanine Green-Based Angiography for Real-Time Assessment of Superficial Brachialis Axial Pattern Flap Vascularization in Two Dogs. Front Vet Sci 2022; 9:859875. [PMID: 35510213 PMCID: PMC9059970 DOI: 10.3389/fvets.2022.859875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 03/09/2022] [Indexed: 11/24/2022] Open
Abstract
This case report describes the method and feasibility of near-infrared angiography (NIRA) to improve the surgical procedure of two superficial brachial axial pattern flaps intraoperatively using two camera systems. Two client-owned dogs were treated for tumors on their antebrachia with wide surgical excision. The defects were closed with a superficial brachial flap in both cases. A different NIRA camera system was used for each case to identify the perforator vessel and flap margins accordingly. Case 1 developed a seroma and healed without further complications. Case 2 developed partial flap necrosis, underwent revision surgery, and healed by secondary intent. NIRA proved useful intraoperatively in identifying the perforator vessel and determining flap margins. As these are only two cases, caution should be used in extrapolating the results.
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Power AM, McKee T, Jordan K, Bergman PJ, Davis KM. Incidence and severity of short-term incisional complications after intraoperative local infiltration of liposomal bupivacaine in dogs. Vet Surg 2022; 51:674-681. [PMID: 35297072 DOI: 10.1111/vsu.13803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 10/28/2021] [Accepted: 12/17/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To report the incidence of short-term incisional complications in dogs receiving intraoperative local infiltration of liposomal bupivacaine. STUDY DESIGN Retrospective study. ANIMALS Client-owned dogs (n = 218). METHODS Medical records were searched for dogs whose surgical site was infiltrated with liposomal bupivacaine. Records were reviewed for complications within 20 days postoperatively. Cases were categorized by: (1) surgical wound classification (clean, clean-contaminated, contaminated); (2) labeled versus off-label use in orthopedic surgery - stifle surgery to address cranial cruciate ligament (CCL) disease versus other orthopedic procedures; and (3) orthopedic versus soft-tissue surgery. RESULTS Complications were documented in 43/218 (19.7%) records, including 27/218 (12.4%) complications that resolved spontaneously or with topical treatment. The incidence of short-term incisional complications did not differ between surgical wound classifications (P = 0.55) or between labeled versus off-label use in orthopedic surgery (P = 0.21). Complications seemed more common after soft-tissue procedures (32/123; 26.0%) than orthopedic procedures (11/95; 11.6%) (P < 0.01). CONCLUSION Surgical wound classification or type of orthopedic procedure did not seem to influence incisional complications of infiltrated surgical sites. Complications were more common after soft-tissue procedures than orthopedic procedures. CLINICAL SIGNIFICANCE Infiltration of surgical sites with liposomal bupivacaine seems safe in a broader range of orthopedic procedures than currently labeled. The results also justify further investigation in soft-tissue surgery.
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Affiliation(s)
- Ashley M Power
- VCA South Shore Animal Hospital, Weymouth, Massachusetts, USA
| | - Talon McKee
- VCA Clinical Studies, California, Los Angeles, USA
| | - Kara Jordan
- VCA South Shore Animal Hospital, Weymouth, Massachusetts, USA
| | | | - Kechia M Davis
- VCA South Shore Animal Hospital, Weymouth, Massachusetts, USA
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Forster K, Cutando LS, Ladlow J, Anderson D, Burton C, Das S, Gibson S, Kulendra N, Emmerson T, Baines S, Rutherford L, Paulino RD, Fontanini R, Compagnone K, De La Puerta B. Outcome of caudal superficial epigastric axial pattern flaps in dogs and cats: 70 cases (2007-2020). J Small Anim Pract 2021; 63:128-135. [PMID: 34937131 DOI: 10.1111/jsap.13467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 11/25/2021] [Accepted: 12/02/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To describe the outcome and complications associated with the use of caudal superficial epigastric axial pattern flaps in dogs and cats. MATERIAL AND METHODS Multicentre retrospective review and descriptive study of clinical records of dogs and cats having undergone caudal superficial epigastric axial pattern flaps between 2007 and 2020. Data retrieved included signalment, aetiology of surgical defect, tumour type, presence/absence of clean surgical margins, presence/absence of post-operative wound infection, use of peri- and post-operative antibiotics, duration of anaesthesia, duration of surgery, presence and duration of hypothermia, presence and duration of hypotension, presence/absence of post-operative surgical drain and length of caudal superficial epigastric axial pattern flap. The incidence of complications and outcomes were documented. RESULTS Seventy cases met the inclusion criteria; 51 dogs and 19 cats. In dogs, 67% of cases developed complications (59% minor, 8% major) and 33% had uneventful wound healing. In cats, 53% of cases developed complications, (47% minor, 5% major) and 47% had uneventful wound healing. In dogs, the percentage of cases experiencing dehiscence, necrosis, seroma, oedema and post-operative infection was 31%, 29%, 26%, 26% and 16% respectively. In cats, this was 26%, 16%, 11%, 0% and 5% respectively. A good overall outcome was seen in 77% of dogs and 79% of cats. A poor overall outcome was seen in 4% of dogs and 0% of cats. CLINICAL SIGNIFICANCE Caudal superficial epigastric axial pattern flaps are traditionally thought more robust than other flaps, yet complication rates remain high, despite a high overall success rate.
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Affiliation(s)
- K Forster
- North Downs Specialist Referrals, The Friesian Buildings 3 and 4, Bletchingley RH1 4QP, UK
| | - L S Cutando
- The Ralph Veterinary Referral Centre, Fourth Avenue Globe Business Park, Marlow SL7 1 YG, UK
| | - J Ladlow
- Hamilton Specialist Referrals, Cressex Business Park, High Wycombe HP12 3SD, UK
| | - D Anderson
- Anderson Moores, The Granary, Bunstead Barns, Poles Lane, Hursley, Winchester, Hampshire, SO21 2LL, UK
| | - C Burton
- Davies Veterinary Specialists, Manor Farm Business Park, Higham Gobion, Hertfordshire, SG5 3HR, UK
| | - S Das
- Davies Veterinary Specialists, Manor Farm Business Park, Higham Gobion, Hertfordshire, SG5 3HR, UK
| | - S Gibson
- Davies Veterinary Specialists, Manor Farm Business Park, Higham Gobion, Hertfordshire, SG5 3HR, UK
| | - N Kulendra
- North Downs Specialist Referrals, The Friesian Buildings 3 and 4, Bletchingley RH1 4QP, UK
| | - T Emmerson
- North Downs Specialist Referrals, The Friesian Buildings 3 and 4, Bletchingley RH1 4QP, UK
| | - S Baines
- Willows Veterinary Centre and Referral Service, Shirley, Solihull, West Midlands B90 4NH, UK
| | - L Rutherford
- The Royal Veterinary College, Hertfordshire, AL9 7TA, UK
| | - R D Paulino
- Dick White Referrals, Station Farm, Six Mile Bottom, Cambridge, CB8 0UH, UK
| | - R Fontanini
- Hospital for Small Animals, Royal (Dick) School of Veterinary Studies and Roslin Institute, Easter Bush Campus, Midlothian, EH25 9RG, UK
| | - K Compagnone
- Northwest Veterinary Specialists, Delamere House, Ashville Point, Beechwood, Sutton Weaver, Runcorn WA7 3FW, UK
| | - B De La Puerta
- North Downs Specialist Referrals, The Friesian Buildings 3 and 4, Bletchingley RH1 4QP, UK
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Villedieu E, Nolff MC, Del Magno S, Emmerson T, Field E, Hattersley R, De La Puerta B, Ragni RA, Baines SJ. Outcome of superficial brachial axial pattern flaps used to close skin defects in dogs: 16 cases (1996-2019). J Small Anim Pract 2021; 63:136-141. [PMID: 34708429 DOI: 10.1111/jsap.13435] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 07/21/2021] [Accepted: 09/19/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To report the complication rate, type of complications and outcome of the superficial brachial axial pattern flap when used for closure of skin defects in dogs. MATERIALS AND METHODS Medical records of dogs treated with a superficial brachial axial pattern flap for closure of a skin defect were reviewed. Information regarding signalment, reason for axial pattern flap use, skin flap size, flap healing, postoperative complications and need for revision surgery was collected. RESULTS Sixteen dogs were included in the study. Indications for the superficial brachial axial pattern flap included closure following tumour removal (15/16, 94%) and management of a non-healing wound on the olecranon (1/16, 6%). Postoperative complications occurred in all dogs and included partial dehiscence (7/16, 44%), partial flap necrosis (6/16. 38%), seroma formation (5/16, 31%), flap oedema (3/16, 19%) and complete flap necrosis (2/16, 13%). Eight flaps (50%) healed without open wound management or additional surgery. Five dogs required open wound management without additional surgery, and three dogs (19%) required revision surgery. CLINICAL SIGNIFICANCE Use of the superficial brachial axial pattern flap was associated with a high rate of complications. Most complications were managed without additional surgery and all wounds eventually healed, in some cases after prolonged open wound management.
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Affiliation(s)
- E Villedieu
- Willows Veterinary Centre and Referral Service, Solihull, B90 4NH, UK
| | - M C Nolff
- FTA Kleintiermedizin, FTA Kleintierchirurgie, Leitung Weichteil und Onkologische Chirurgie, Tierspital Zürich, Zürich, Switzerland
| | - S Del Magno
- Department of Veterinary Medical Sciences, Alma Mater Studorium, University of Bologna, Bologna, Italy
| | - T Emmerson
- North Downs Specialist Referrals, Bletchingley, RH1 4QP, UK
| | - E Field
- Highcroft Veterinary Referrals, Bristol, BS14 9BE, UK
| | - R Hattersley
- Dick White Referrals, Cambridgeshire, CB8 0UH, UK
| | - B De La Puerta
- North Downs Specialist Referrals, Bletchingley, RH1 4QP, UK
| | - R A Ragni
- Village Vet West Hampstead, London, NW6 1LN, UK
| | - S J Baines
- Willows Veterinary Centre and Referral Service, Solihull, B90 4NH, UK
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13
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Price JB, Wood CJ, Liptak JM. The pinna composite flap for wound reconstruction in a dog. Vet Surg 2021; 50:1704-1708. [PMID: 34562032 DOI: 10.1111/vsu.13732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 08/10/2021] [Accepted: 09/01/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To report the surgical technique and outcome of the use of a pinna composite flap for reconstruction of a wound defect following wide surgical resection of a mast cell tumor. ANIMALS A 4-year-old female spayed golden doodle. STUDY DESIGN Clinical case report. METHODS A dog with a histologically confirmed cutaneous mast-cell tumor at the base of the ear was treated with a wide surgical resection, including total ear canal ablation and lateral bulla osteotomy. The defect could not be closed primarily and, as a result, the defect was reconstructed with a composite pinna flap. RESULTS Partial avascular necrosis of the distal aspect of the composite flap required debridement and closure 13 days after the initial surgery. The flap was fully healed at 27 days postoperatively. The dog had facial nerve paralysis, which had not resolved by 45 weeks postoperatively. CONCLUSION The surgical technique described in this report is novel. The use of the pinna as a composite flap is a novel reconstructive option for dorsal and dorsolateral head wounds.
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Affiliation(s)
| | | | - Julius M Liptak
- Capital City Small Animal Mobile Surgery, Ottawa, Ontario, Canada
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14
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Pappa E, Zacharopoulou T, Georgiou S, Sideri A, Tsioli V. Genicular axial pattern flap for coverage of a hind limb defect caused by dog bites in a ewe. VETERINARY RECORD CASE REPORTS 2021. [DOI: 10.1002/vrc2.3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Elena Pappa
- Faculty of Veterinary Medicine University of Thessaly‐Karditsa Karditsa Greece
| | | | - Stefanos Georgiou
- Faculty of Veterinary Medicine University of Thessaly‐Karditsa Karditsa Greece
| | - Aikaterini Sideri
- Faculty of Veterinary Medicine University of Thessaly‐Karditsa Karditsa Greece
| | - Vassiliki Tsioli
- Faculty of Veterinary Medicine University of Thessaly‐Karditsa Karditsa Greece
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15
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Spåre P, Ljungvall I, Ljungvall K, Bergström A. Evaluation of post-operative complications after mastectomy performed without perioperative antimicrobial prophylaxis in dogs. Acta Vet Scand 2021; 63:35. [PMID: 34461957 PMCID: PMC8407595 DOI: 10.1186/s13028-021-00600-3] [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: 07/18/2020] [Accepted: 08/23/2021] [Indexed: 11/17/2022] Open
Abstract
Background Mastectomy is the most common procedure for treatment of mammary tumours. Dogs undergoing mastectomy have a risk of developing surgical site infections (SSI) and other postoperative complications. However, potential risk factors associated with such complications have been sparsely investigated. Thus, the objective of this retrospective study was to determine the incidence of, and identify risk factors for, SSI and non-SSI postoperative complications after mastectomy performed without perioperative antimicrobial prophylaxis in privately owned otherwise clinically healthy dogs. Results Medical records were reviewed retrospectively for 135 client-owned female dogs, 10–35 kg in weight and three to 10 years of age, which had undergone mastectomy due to mammary tumours at three referral animal hospitals in Sweden over a 3-year period. Twelve (8.9%) dogs developed SSI, and 21 dogs (17.1%) dogs suffered a non-SSI postoperative complication. The incidence of SSI and all complications (SSI and non-SSI) were higher in dogs that had two to three (SSI: P = 0.036 and all complications: P = 0.0039) and four to five (SSI and all complications: P = 0.038) mammary glands excised, compared to dogs that had one mammary gland excised. The incidence of SSI was 1.7% (n = 1/60) in dogs that had one gland removed. The incidence of non-SSI postoperative complications was higher in dogs with a higher body weight (P = 0.02). Conclusions The incidence of SSI was lower than or similar to previously reported incidences of SSI in dog populations that have undergone tumour excisional surgery, despite the fact that dogs in the present study had not received perioperative antibiotics. Dogs that had two or more glands excised had an increased risk of developing SSI and non-SSI complications compared to dogs that had one gland excised. Furthermore, higher BW was associated with an increased risk of non-SSI complications. Results from the study indicate that routine use of perioperative antibiotics in tumour excisional surgery can be questioned, at least in single gland mastectomy in otherwise clinically healthy dogs.
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16
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Albernaz VGP, Oblak ML, Quitzan JG. Angularis oris axial pattern flap as a reliable and versatile option for rostral facial reconstruction in cats. Vet Surg 2021; 50:1688-1695. [PMID: 34293186 DOI: 10.1111/vsu.13686] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 05/07/2021] [Accepted: 07/07/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To evaluate outcomes associated with the use of an angularis oris axial pattern flap (AOAPF) for rostral facial reconstruction in cats. ANIMALS Nine adult client-owned cats. STUDY DESIGN Short case series. METHODS Ten AOAPF were performed in nine cats after resection of a tumor. Wounds were located at the nose, infraorbital, supraorbital, frontal, eye, and ear canal region. Orbital exenteration (n = 3), pinnectomy (n = 2), nasal planum resection, total ear canal ablation (n = 2), and partial eyelid reconstruction (n = 3) were performed. RESULTS Short-term postoperative complications included flap edema (n = 10), suture dehiscence (n = 3), and distal tip necrosis (n = 3). All wounds resulting from minor complications healed by second intention in 5-15 days. Long-term complications included epiphora (n = 2), frequent grooming around the eyes (n = 2), and enucleation due to corneal ulcer secondary to impaired postoperative eyelid function (n = 1). Tumor recurrence occurred in 3 cases. CONCLUSION The AOAPF was a versatile and reliable option for rostral facial reconstruction in cats with acceptable long-term outcomes.
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Affiliation(s)
- Vinicius G P Albernaz
- School of Veterinary Medicine and Animal Science, São Paulo State University, Botucatu, Brazil
| | - Michelle L Oblak
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Juliany G Quitzan
- School of Veterinary Medicine and Animal Science, São Paulo State University, Botucatu, Brazil
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17
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de la Puerta B, Buracco P, Ladlow J, Emmerson T, Del Magno S, Field E, Baines S. Superficial temporal axial pattern flap for facial reconstruction of skin defects in dogs and cats. J Small Anim Pract 2021; 62:984-991. [PMID: 34240420 DOI: 10.1111/jsap.13384] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 05/07/2021] [Accepted: 05/15/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Report the use, complications and outcome of the superficial temporal axial pattern flap (STA) when used for closure of skin defects localised to the maxillofacial region in dogs and cats. MATERIALS AND METHODS Multi-centre retrospective cohort study. Medical records of dogs and cats treated with a STA flap for closure of skin defects were reviewed. Information regarding signalment, reason for axial pattern flap use, flap size, flap healing, postoperative complications including need for surgical revision and overall outcome were collected. RESULTS Nineteen patients were included: nine dogs and 10 cats. Indications for the STA flap included closure of defects following excision of tumours (18/19, 94.7%) and fungal granuloma resection (1/19, 5.2%). 100% flap survival occurred in 17 of 19 flaps (89.4%). Postoperative complications occurred in eight of 19 flaps (42.1%). A major complication of full thickness partial necrosis of the flap occurred in one of 19 cases (5.2%), where the flap length exceeded recommended guidelines. Minor complications related to the flap were seen in four of 19 cases (21%). This included partial thickness flap necrosis, flap oedema and wound discharge. Complications related to the location of surgery (5/19, 26.3%) included mild ectropion, mild exposure of the eye, reduced ability to blink and subcutaneous emphysema. CLINICAL SIGNIFICANCE The STA flap is a good option for closure of a skin defect localised to the maxillofacial region. STA flaps were associated with a high percentage of survival and a low incidence of major complications.
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Affiliation(s)
- B de la Puerta
- North Downs Specialist Referrals, The Friesian Buildings 3 and 4, The Brewer Street, Dairy Business Park, Bletchingley, RH1 4QP, UK
| | - P Buracco
- Department of Veterinary Science, University of Turin, Largo Paolo Braccini, 2 10095 Grugliasco, TO, Italy
| | - J Ladlow
- Hamilton Specialist Referrals, Cressex Business Park, Unit 5, Halifax Road, High Wycombe, Buckinghamshire, HP12 3SD, UK
| | - T Emmerson
- North Downs Specialist Referrals, The Friesian Buildings 3 and 4, The Brewer Street, Dairy Business Park, Bletchingley, RH1 4QP, UK
| | - S Del Magno
- Department of Veterinary Medical Sciences, University of Bologna, via Tolara di Sopra 50, 40064 Ozzano dell'Emilia, BO, Italy
| | - E Field
- Highcroft Veterinary Referrals, 615 Wells Road, Bristol, BS14 9BE, UK
| | - S Baines
- Willows Veterinary Centre and Referral Service, Highlands Road, Shirley, Solihull, B90 4NH, UK
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18
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Ciou MJ, Yeh LS. Reconstruction of a large nasal-facial defect using an augmented temporal myocutaneous tube flap in a dog. Vet Med Sci 2021; 7:1524-1529. [PMID: 34132065 PMCID: PMC8464263 DOI: 10.1002/vms3.548] [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] [Indexed: 11/15/2022] Open
Abstract
The muzzle region of dogs contains various composite tissues, which are challenging to recreate during reconstruction. Small or moderate facial/nasal defects can be closed primarily or left for second‐intention healing. However, larger defects require the application of composite tissue or labial advancement flaps. Axial pattern flaps based on the caudal auricular artery, superficial temporal artery (STA), angularis oris artery, and other cutaneous arteries have been reported. In our case, we aim to report the reconstruction of a large composite defect of the rostral and dorsal nasal regions in a dog using an augmented, axial myocutaneous flap based on bilateral STAs. This is a clinical report on a spayed female mixed‐breed dog (age, 7 years; weight, 15 kg), in which a large‐scale nasal–facial composite tissue defect was surgically reconstructed using an axial myocutaneous flap based on bilateral STA branches. A delay technique was applied to prefabricate the flap to enrich the blood supply. New nostrils were created on a folded, rostral hard palate. As a result, the axial tube rotational flap was successfully transferred. The use of delay technique for prefabricating the tube flap optimized its size and survival. In addition to the folded rostral hard palate, the flap fully closed the defects on the face and nose. Functional and cosmetic outcomes were satisfactory, with minimal donor‐site morbidity. In, conclusion, a large‐scale nasal–facial defect in a dog was successfully reconstructed using an augmented tube pedicle flap based on the bilateral STAs, which may, thus, be used to repair very large facial‐nasal defects in dogs. A large‐scale nasalfacial defect in a dog was successfully reconstructed using an augmented tube pedicle flap based on the bilateral STAs, which may, thus, be used to repair very large facial‐nasal defects in dogs.
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Affiliation(s)
- Mei-Jyun Ciou
- Veterinary Teaching Hospital, National Taiwan University, Taipei, Taiwan
| | - Lih-Seng Yeh
- Veterinary Teaching Hospital, National Taiwan University, Taipei, Taiwan.,Institute of Veterinary Clinical Sciences, School of Veterinary Medicine, National Taiwan University, Taipei, Taiwan
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19
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Guzu M, Rossetti D, Hennet PR. Locoregional Flap Reconstruction Following Oromaxillofacial Oncologic Surgery in Dogs and Cats: A Review and Decisional Algorithm. Front Vet Sci 2021; 8:685036. [PMID: 34095284 PMCID: PMC8175653 DOI: 10.3389/fvets.2021.685036] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 04/21/2021] [Indexed: 11/13/2022] Open
Abstract
Primary treatment of most oromaxillofacial tumors in dogs and cats is resective surgery. Management of malignant tumors may be very challenging as wide/radical free-margin surgical removal must be achieved while preserving vital functions. Removal of orofacial tumors may result in large defects exposing the oral cavity or creating a communication with the nasal, pharyngeal, or orbital cavities. Such defects require orofacial reconstruction in order to restore respiratory and manducatory functions. The veterinary surgeon must be familiar with reconstructive techniques in order to prevent the inability of closing the defect, which could lead to an insufficient resection. Small oral defects exposing the nasal cavity are best closed with local random mucosal flaps. Closure of large oral defects may be better achieved with a facial or major palatine-based axial-pattern flap. Small to moderate facial defects can be closed with local advancement or transposition skin flaps. Reconstruction of large facial defects often requires the use of locoregional axial pattern flaps such as the caudal auricular, the superficial temporal, or the facial (angularis oris) myocutaneous axial pattern flaps. Recent publications have shown that the facial (angularis oris) flap is a very versatile and reliable flap in orofacial reconstructive surgery. A surgical decision algorithm based on the size, nature, and location of the defect is proposed.
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Affiliation(s)
- Michel Guzu
- Dentistry and Oromaxillofacial Surgery Unit, Department of Surgery, ADVETIA Centre Hospitalier Vétérinaire, Vélizy-Villacoublay, France
| | - Diego Rossetti
- Department of Surgery, CHV ADVETIA, Vélizy-Villacoublay, France
| | - Philippe R. Hennet
- Dentistry and Oromaxillofacial Surgery Unit, Department of Surgery, ADVETIA Centre Hospitalier Vétérinaire, Vélizy-Villacoublay, France
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20
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Del Magno S, Morello E, Iussich S, Gola C, Dalpozzo B, Annoni M, Martano M, Massari F, Giacobino D, Piras LA, Stefanello D, Buracco P. Evaluation of the neoplastic infiltration of the skin overlying canine subcutaneous soft tissue sarcomas: An explorative study. Vet Comp Oncol 2021; 19:304-310. [PMID: 33423367 DOI: 10.1111/vco.12676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 12/17/2020] [Accepted: 01/05/2021] [Indexed: 11/24/2022]
Abstract
Studies regarding the neoplastic infiltration of the skin overlying canine subcutaneous soft tissue sarcoma (sSTS) are lacking. In case of the absence of tumor infiltration, there would be the possibility of leaving this unaffected skin in place, thus simplifying surgery. The aim of the study was to investigate whether the skin overlying sSTSs is infiltrated by neoplastic cells. Dogs with sSTSs treated surgically were prospectively enrolled. After excision, the skin was dissected from the tumor along the natural surgical plane of cleavage and histologically evaluated. Twenty-nine dogs with an sSTS were included (22 grade I, 6 grade II, and 1 grade III). The sSTS-overlying skin was not tumor-infiltrated in 14/29 cases (48.3%). A higher frequency of infiltration was observed in higher grade sSTSs (grades II and III, 100%; P = .006); nevertheless, 8/22 grade I sSTSs (36%) also showed cutaneous infiltration. This infiltration involved the dermis of the skin directly in contact with the tumor (multifocal in 11 and diffuse in four cases). Although the cutaneous tumor infiltration is less frequent in grade I sSTSs and a wide excision may still be the safest treatment for any sSTS for a greater possibility of local control, this study opens the possibility to a less aggressive cutaneous excision, but still with a local curative intent, as only the skin directly in contact with the sSTS has been proven to be tumor-infiltrated. Additional studies are warranted to confirm that excision of only this skin may guarantee a complete local control, especially in lower-grade sSTSs.
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Affiliation(s)
- Sara Del Magno
- Department of Veterinary Medical Sciences, University of Bologna, Ozzano dell'Emilia, Italy
| | - Emanuela Morello
- Department of Veterinary Science, University of Turin, Grugliasco, Italy
| | - Selina Iussich
- Department of Veterinary Science, University of Turin, Grugliasco, Italy
| | - Cecilia Gola
- Department of Veterinary Science, University of Turin, Grugliasco, Italy
| | - Boris Dalpozzo
- Clinica Veterinaria dell'Orologio, Sasso Marconi, Bologna, Italy
| | | | - Marina Martano
- Department of Veterinary-Medical Sciences, University of Parma, Parma, Italy
| | | | - Davide Giacobino
- Department of Veterinary Science, University of Turin, Grugliasco, Italy
| | - Lisa Adele Piras
- Department of Veterinary Science, University of Turin, Grugliasco, Italy
| | | | - Paolo Buracco
- Department of Veterinary Science, University of Turin, Grugliasco, Italy
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21
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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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22
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Simpson M, Welsh E. Simultaneous use of a lateral caudal and caudal superficial epigastric axial pattern flap for wound closure in a dog. VETERINARY RECORD CASE REPORTS 2019. [DOI: 10.1136/vetreccr-2019-001025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Matthew Simpson
- Vets Now 24/7 Emergency and Speciality HospitalGlasgowUK
- Hospital for Small AnimalsRoyal (Dick) School of Veterinary StudiesThe University of EdinburghRoslinMidlothianUK
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23
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Emmerson T, de la Puerta B, Polton G. Genicular artery axial pattern flap for reconstruction of skin defects in 22 dogs. J Small Anim Pract 2019; 60:529-533. [PMID: 31245838 DOI: 10.1111/jsap.13045] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 02/15/2019] [Accepted: 04/10/2019] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To report the use of the genicular artery axial pattern flap and the frequency and severity of complications in a consecutive series of clinical cases. MATERIALS AND METHODS Medical records from one referral centre were retrospectively reviewed for cases requiring reconstruction using a genicular axial pattern flap between January 2012 and February 2018. RESULTS Twenty-two dogs were included. Skin defects ranging from 12.6 to 81 cm2 (mean 32 cm2 ) on the lateral and cranial crus were successfully closed using the genicular artery axial pattern flap. Average flap survival was 99.1% with two dogs developing distal flap necrosis. Minor complications occurred in eight dogs (36%) including minor wound dehiscence, seroma formation and infection. Major complications requiring further surgery occurred in three dogs (13.6%). CLINICAL SIGNIFICANCE The genicular artery axial pattern flap is useful in the reconstruction of small- to medium-sized skin defects of the lateral and cranial crus. The flap may be more robust and offer better viability than reported previously in experimental studies.
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Affiliation(s)
- T Emmerson
- North Downs Specialist Referrals, Bletchingley, Surrey, UK
| | - B de la Puerta
- North Downs Specialist Referrals, Bletchingley, Surrey, UK
| | - G Polton
- North Downs Specialist Referrals, Bletchingley, Surrey, UK
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24
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Proot JLJ, Jeffery N, Culp WTN, Buracco P, de la Puerta B, Williams JM, Ladlow JF, Field EJ, Nelissen P, Ragni RA, Pope JFA, Baines SJ, Liptak JM, Nicholson I. Is the caudal auricular axial pattern flap robust? A multi-centre cohort study of 16 dogs and 12 cats (2005 to 2016). J Small Anim Pract 2018; 60:102-106. [DOI: 10.1111/jsap.12946] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 07/13/2018] [Accepted: 08/10/2018] [Indexed: 11/29/2022]
Affiliation(s)
| | - N. Jeffery
- Department of Small Animal Clinical Sciences; Texas A&M University; College Station Texas 77843 USA
| | - W. T. N. Culp
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine; University of California-Davis; Davis California 95616 USA
| | - P. Buracco
- Department of Veterinary Science; University of Torino; Torino 10095 Italy
| | | | - J. M. Williams
- Vets Now 24/7 Hospital Manchester; Manchester M45 6TQ UK
| | - J. F. Ladlow
- Department of Veterinary Medicine; University of Cambridge; Cambridge CB3 0ES UK
| | - E. J. Field
- Highcroft Veterinary Referrals; Bristol BS14 9BE UK
| | | | - R. A. Ragni
- Blue Cross Animal Hospital; London SW19 1BD UK
| | - J. F. A. Pope
- Hillgarth, The Wrangle Compton Martin; Bristol BS40 6LB UK
| | - S. J. Baines
- Willows Veterinary Centre & Referral Service; West Midlands, B90 4NH UK
| | - J. M. Liptak
- Canada - Alta Vista Animal Hospital; Ottawa Ontario K1T 1M9 Canada
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25
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Cavalcanti JVJ, Barry SL, Lanz OI, Barnes K, Coutin JV. Reverse Saphenous Conduit Flap in 19 Dogs and 1 Cat. J Am Anim Hosp Assoc 2018; 54:213-218. [PMID: 29757664 DOI: 10.5326/jaaha-ms-6716] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The purpose of this retrospective study was to report the outcomes of 19 dogs and 1 cat undergoing reverse saphenous conduit flap between 1999 and 2016. Reverse saphenous conduit flap was used to treat traumatic wounds and wounds resulting from tumor excision in the hind limb; the majority of cases had medial shearing injuries. All animals had complete flap survival. In five animals (20%), minor donor site dehiscence occurred, which did not require surgery. Other postoperative complications included signs of severe venous congestion in one dog. Reverse saphenous conduit flap is a useful technique to repair skin defects of the distal hind limb.
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Affiliation(s)
- Jacqueline V J Cavalcanti
- From the Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Blacksburg, Virginia (J.V.J.C., S.L.B., O.I.L.); Louisiana State University School of Veterinary Medicine, Baton Rouge, Louisiana (K.B.); and Veterinary Specialists of Greater New Orleans, Metairie, Louisiana (J.V.C.)
| | - Sabrina L Barry
- From the Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Blacksburg, Virginia (J.V.J.C., S.L.B., O.I.L.); Louisiana State University School of Veterinary Medicine, Baton Rouge, Louisiana (K.B.); and Veterinary Specialists of Greater New Orleans, Metairie, Louisiana (J.V.C.)
| | - Otto I Lanz
- From the Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Blacksburg, Virginia (J.V.J.C., S.L.B., O.I.L.); Louisiana State University School of Veterinary Medicine, Baton Rouge, Louisiana (K.B.); and Veterinary Specialists of Greater New Orleans, Metairie, Louisiana (J.V.C.)
| | - Katherine Barnes
- From the Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Blacksburg, Virginia (J.V.J.C., S.L.B., O.I.L.); Louisiana State University School of Veterinary Medicine, Baton Rouge, Louisiana (K.B.); and Veterinary Specialists of Greater New Orleans, Metairie, Louisiana (J.V.C.)
| | - Julia V Coutin
- From the Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Blacksburg, Virginia (J.V.J.C., S.L.B., O.I.L.); Louisiana State University School of Veterinary Medicine, Baton Rouge, Louisiana (K.B.); and Veterinary Specialists of Greater New Orleans, Metairie, Louisiana (J.V.C.)
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26
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Travis BM, Hayes GM, Vissio K, Harvey HJ, Flanders JA, Sumner JP. A quilting subcutaneous suture pattern to reduce seroma formation and pain 24 hours after midline celiotomy in dogs: A randomized controlled trial. Vet Surg 2017; 47:204-211. [DOI: 10.1111/vsu.12754] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 06/30/2017] [Accepted: 07/19/2017] [Indexed: 11/28/2022]
Affiliation(s)
| | | | - K. Vissio
- Cornell University Hospital for Animals; Ithaca New York
| | - H. J. Harvey
- Cornell University Hospital for Animals; Ithaca New York
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