Free skin grafts for immediate wound coverage following tumour resection from the canine distal limb

Abstract

Free grafting can be used reliably to reconstruct extensive surgical wounds in the distal limb in dogs after large tumour resection without the need for a delay to allow granulation tissue to form. Immediate grafting is useful as an alternative to other reconstructive surgical techniques or second intention healing.

Second intention healing after wide local excision of soft tissue sarcomas in the distal aspects of the limbs in dogs: 31 cases (2005–2012)

“…4 There is controversy regarding the appropriate surgical treatment for soft tissue sarcomas in the distal Second intention healing after wide local excision of soft tissue sarcomas in the distal aspects of the limbs in dogs: 31 cases (2005-2012) aspects of limbs. Various reconstruction techniques of distal aspects of limbs have been described, including axial pattern flaps, [16][17][18][19] pedicle and bipedicle skin flaps, 20,21 free tissue transfer, 22,23 skin grafts, 24,25 and tissue expansion. A large range of recurrence rates have been reported for planned marginal excision as the sole treatment of soft tissue sarcomas in distal aspects of limbs, including recurrence rates of 11% for grade I spindle cell tumors 12 and 37% a and 80% 9 for all grades of soft tissue sarcomas.…”

Combined caudal‐superficial‐epigastric axial pattern flap and full‐thickness buccal mucosa graft for single‐stage preputial reconstruction in six dogs

“…Conversely, the oral graft failed in dog 4; we speculate that one important predisposing factor for failure in this dog was that he did not wear the Elizabethan collar consistently after discharge, thus allowing licking of the surgical site. Movement between the graft and the recipient bed has been identified as a cause of full‐thickness skin grafts failure ( Pope , Tong & Simpson ); we thus suspect that graft movement and trauma caused by licking were major causes of graft failure in this case. Further causes of graft failure were not investigated as no other causative clinical conditions (such as local infection or seroma formation) were suspected.…”

Negative pressure wound therapy using a portable single‐use device for free skin grafts on the distal extremity in seven dogs

“…Complete healing by second intention has been reported in 93% of cases after excision of distal limb tumours, with a median time to healing of 53 days (range, 25–179 days) and 10% morbidity from skin contracture over the carpal joint. In comparison, skin grafting may allow the surgeon to more confidently perform curative‐intent excision of distal limb tumours, with immediate graft placement onto fresh surgical wounds, including exposed muscles, tendons and retinacula of the distal limb, previously shown to result in successful graft survival …”

“…Management of these wounds can be challenging because of the lack of skin available for primary closure. Free skin grafts have been successfully used to treat both chronic and acute extremity wounds in dogs, but common causes of graft failure are separation from the wound bed caused by fluid accumulation, movement and infection . Negative pressure wound therapy (NPWT) has the potential to eliminate these problems and is used extensively in human surgery to support skin grafts and flaps.…”