Novel use of a combination of extracellular matrices for wound healing following resection of a large inferior eyelid mass in a miniature Hereford

CASE DESCRIPTION

A 9-month-old miniature Hereford heifer was evaluated for a mass on the right inferior eyelid that had progressed in size over 3 months.

CLINICAL FINDINGS

Physical examination revealed a firm, ulcerated, pedunculated mass on the right inferior eyelid that extended from the medial quarter to beyond the lateral canthus of the eye. The base of the mass measured 7.4 × 6.7 cm, and the dorsal margin of the base of the mass was approximately 3 mm ventral to the inferior eyelid margin. Histologic evaluation of incisional biopsy specimens from the mass was consistent with fibrosarcoma.

TREATMENT AND OUTCOME

The mass was surgically resected with care taken to preserve the eyelid margin. The resulting 10 × 8.5-cm surgical wound was treated with adjunct CO₂ laser therapy and closed by primary closure at its medial and central aspects and placement of a 4.6 × 2.6-cm lyophilized equine amnion multilayer graft and 2 sheets of 4-ply porcine small intestinal submucosa at its lateral aspect. The grafts were kept moist by alternating topical antimicrobial and artificial tear ointments for 3 weeks. The wound healed without complications, resulting in a functional and aesthetically pleasing outcome despite the development of moderate ectropion at the lateral aspect of the inferior eyelid.

CLINICAL RELEVANCE

Results suggested that a combination of extracellular matrix scaffolds may be an alternative to extensive skin flaps for management of large dermal wounds, particularly wounds resulting from blepharoplasty where preservation of an eyelid margin is desired.

Successful, Full-Thickness Skin Graft in a Bald Eagle (Haliaeetus leucocephalus)

A subadult, male bald eagle (Haliaeetus leucocephalus) was evaluated after being found unable to fly, with large eschars on the dorsal head and right stifle. Because of the appearance and location, the lesions were believed to be caused by an electrical injury. Treatment included oral antibiotics, nonsteroidal anti-inflammatory drugs, pain medication, surgical debridement of the eschars, and trephining of the affected inner table of the cranium. A full-thickness skin graft was performed to expedite wound healing and minimize holding time. After 6 weeks, the bird had new feather growth on its dorsal head and was released. This is the first report, to our knowledge, of a nonmesh, full-thickness skin graft in an avian species. Full-thickness skin grafts should be considered as a surgical option in juvenile or adult avian patients with large dorsal head wounds.

Technological Advances in Wound Treatment of Exotic Pets

Although most research about the use of technological advances for wound healing was performed in laboratory animals but oriented to human medicine, recent technological advances allowed its application not only to small animals but also to exotic pets. This article reviews the literature available about some of these techniques (negative wound pressure therapy, photobiomodulation [laser therapy], electrical stimulation therapy, therapeutic ultrasonography, hyperbaric oxygen therapy), and other advances in wound management (skin expanders, xenografts, and bioengineered autologous skin substitutes) in exotic pet species.

Short-term survival and effects of transmitter implantation into western grebes using a modified surgical procedure

Two pilot trials and one study in a closely related grebe species suggest that Western grebes (Aechmophorus occidentalis) will not tolerate intracoelomic transmitter implantation with percutaneous antennae and often die within days of surgery. Wild Western grebes (n = 21) were captured to evaluate a modified surgical technique. Seven birds were surgically implanted with intracoelomic transmitters with percutaneous antennae by using the modified technique (transmitter group), 7 received the same surgery without transmitter implantation (celiotomy group), and 7 served as controls (only undergoing anesthesia). Modifications included laterally offsetting the body wall incision from the skin incision, application of absorbable cyanoacrylate tissue glue to the subcutaneous space between the body wall and skin incisions, application of a waterproof sealant to the skin incision after suture closure, and application of a piece of porcine small intestine submucosa to the antenna egress. Survival did not differ among the 3 groups with 7 of 7 control, 6 of 7 celiotomy, and 6 of 7 transmitter birds surviving the 9-day study. Experimental birds were euthanized at the end of the study, and postmortem findings indicated normal healing. Significant differences in plasma chemistry or immune function were not detected among the 3 groups, and only minor differences were detected in red blood cell indices and plasma proteins. After surgery, the birds in the transmitter group spent more time preening tail feathers than those in the control and celiotomy groups. These results demonstrate that, in a captive situation, celiotomy and intracoelomic transmitter implantation caused minimal detectable homeostatic disturbance in this species and that Western grebes can survive implantation of intracoelomic transmitters with percutaneous antennae. It remains to be determined what potential this modified surgical procedure has to improve postoperative survival of Western grebes that are intracelomically implanted with transmitters with percutaneous antennae and released into the wild.

Emergency and critical care of pet birds

Critically ill birds must be assessed accurately and provided with immediate supportive care. This article reviews the assessment and diagnostics required for evaluating the critical avian patient. The most common emergencies seen in pet birds are discussed. Diagnostics and treatments protocols are provided to help direct the practitioner toward a complete recovery.