Use of self‐inflating tissue expanders in equine surgery: A prospective study of 20 cases

Abstract

Summary Background Tissue expansion is a well‐established technique in reconstructive surgery. Self‐inflating tissue expanders (STE) have not been widely adopted by veterinary surgeons, and clinical descriptions of their use in horses are lacking. Objective To describe the indications, clinical experiences and outcomes of a series of equine cases that used a hydrogel‐based STE to assist soft tissue reconstruction. Study design Prospective clinical study. Methods Case details, surgical techniques and outcomes were recorded for horses requiring use of an STE, using a predesigned data collection sheet completed by the treating surgeon. All horses underwent two surgical procedures as part of their treatment: one to place the STE(s) and a second to remove the device(s) and perform reconstructive surgery using the expanded tissue. Results Twenty horses had STEs implanted at seven clinics and had sufficient follow‐up for inclusion in the study. Indications for using the expanders included the following: expansion of skin prior to excision of a neoplastic lesion (n = 13), repair of a sinocutaneous fistula (n = 2), repair of chronic scarring or a nonhealing wound (n = 2), repair of a full‐thickness ear pinna defect (n = 1) and repair of a rectovestibular injury (n = 2). The degree of tissue expansion was graded as good in 19/20 cases (95%) and provided sufficient tissue to cover the entire defect in 11/20 cases (55%). STE‐associated complications occurred in 9/20 horses (45%), but none of these complications were serious. The final clinical outcome was graded by the treating surgeon as good or excellent in 15/20 horses (75%). Main limitations Only one type of STE device is described, and its use was not compared with other treatments. Information regarding use of the STE at locations other than the head (n = 3) is limited. Conclusions Use of a STE device in horses resulted in no serious complications and provided a good outcome in a variety of equine clinical cases.

Review of skin grafting in equine wounds: Indications and techniques

“…Pedicle grafting may be performed in regions where there is enough skin close to the wound defect to rotate skin into the area while leaving some vascular supply intact. Recently, the use of self-inflating tissue expanders has been described in 20 surgical cases with 75% of cases reaching an excellent clinical outcome (Cullen et al, 2023). The Examples where pedicle grafting has been performed include conjunctival pedicle grafts which are commonly used in ophthalmic procedures (Gilger et al, 2005;Holmberg, 1981;McMullen Jr, 2023) and to cover fistulas over the maxillary sinus in the head region (Yoshimura et al, 2020).…”