Outcome of reconstruction of cutaneous limb defects in dogs using hygroscopic “self‐inflating” tissue expanders

Abstract

Self-inflating tissue expanders can be used as an alternative for the reconstruction of limb defects in dogs in which direct primary closure would otherwise not be achievable. Defects below the carpus and tarsus are more challenging to treat with this method.

Use of a chronic soft tissue expansion device to facilitate blepharoplasty in a horse with lower‐lid cicatricial ectropion with a 14‐year follow‐up

“…10,11 STEDs have been utilized in veterinary patients to a lesser extent, with previously reported applications involving closure of a nasal fistula in a horse, resolution of a rhomboid scar on a horse, resolution of a canine and bovine tail base scar and wound closures of the canine and equine distal limb. [12][13][14] Horses have less skin available in their faces and surrounding their orbits compared to small animal species, and so oculoplastic procedures after tissue loss in these regions are challenging. This has been previously documented within F I G U R E 6 At day fourteen post-operatively, the region of tension-relieving incisions were granulating and the surgical site was healing uneventfully.…”

The Use of Self-Inflating Hygroscopic Tissue Expanders to Facilitate Osteosarcoma Removal in a Massasauga Rattlesnake (Sistrurus catenatus)

“…Reports of skin stretching and tissue expansion first appeared in the veterinary medical literature during the 1980s. The initial publications described the clinical utility of these methods in dogs and horses [1][2][3], methods which have since been refined for use in a variety of domestic species and applications [4][5][6][7][8][9][10][11][12]. Adapted from human reconstructive medicine, skin stretching and tissue expansion are two different methods that enable veterinary surgeons to close large dermal wounds or surgical defects in regions of high tension.…”

“…Achieving primary closure prevents complications and associated wound management that is necessitated by secondary intention healing [13]. In domestic mammals, these techniques are most commonly applied to cutaneous defects of the distal limbs or in regions of significant skin loss on the axilla [8,11,12,14,15]. They are employed as part of a delayed reconstruction plan and can be used to augment or replace other tension-relieving surgical techniques such as orienting incisions parallel to tension lines, undermining, placing walking sutures, performing tension-releasing incisions, and using skin flaps or grafts.…”

“…This technique has met with variable success and popularity in veterinary patients due to the cost, relative size of available implants, and necessity of maintaining a SQ or external port for intermittent expansion [4,15,24,25]. However, the development of small hygroscopic self-inflating tissue expanders (STEs) has led to potentially improved utility and outcome [11]. STEs, first developed for use in human medicine in the 1970s and 1980s [23], function via fluid absorption by an osmotically active hydrogel core that generates a spontaneous volume increase by drawing in water from surrounding tissues.…”

“…Similarly, the extent of expansion is determined by the silicone coating, which acts to contain the expanding core [27]. The use of STEs is well established in human reconstructive surgery, and they have recently been used for malignant and benign tumor resection and primary wound closure in veterinary medicine [11,25,27,28]. To the authors' knowledge, the use of STEs has not previously been reported in an exotic or nonmammal species.…”