Wound Drainage from Under Full‐thickness Skin Grafts in Dogs Part II. Effect on Cosmetic Appearance

Abstract

Four skin grafting procedures were performed on both sides of the chests of 12 dogs to evaluate the effect of wound drainage on the survival and cosmetic appearance of the grafts. The techniques evaluated were a sheet graft, (control), continuous low level suction, piecrust incisions, and nonexpanded mesh graft. Graft viability was assessed on the 10th postoperative day by visual inspection. The mean survival rate for all grafts was 90%. No significant difference between graft types was observed.Hair growth on each graft was assessed 3 months postoperatively as "normal" (resembled that on the surrounding skin), "moderate" (thickness of hair growth was less than normal but would nearly conceal the underlying skin), "sparse" (a few hairs were present and the skin below was easily visible), and "none" (no hair growth). No statistical differences in categories of hair growth were detected within types or between types of grafts. Hair growth also was assessed as "acceptable" (those areas having normal and moderate hair growth) and "nonacceptable" (hair growth sparse or none). No difference between graft types was noted. All types exhibited a significantly greater area of acceptable than nonacceptable hair growth. KIN GRAFTING IN DOGS and cats is performed to S provide a durable and cosmetic covering. The cosmetic appearance, which encompasses both the quality of hair regrowth as well as the color and texture of the skin, is reported to be more acceptable with fullthickness grafting than with split-thickness grafting.lP3 Full-thickness skin grafting frequently results in a hairy skin indistinguishable from the surrounding area when the donor site is matched with the local color and direction of hair g r o~t h .~,~ Skin graft survival is dependent on the rapid reestablishment of an adequate circulation to provide nutrition and to dispose of metabolic waste products.6-8 The formation of a hematoma or seroma under a graft is reported to be the most common cause of graft failure .9-13Factors affecting hair regrowth have not been studied extensively. The purposes of this study were to determine the effects of wound drainage on skin graft survival and cosmetic appearance of full-thickness skin grafts. Materials and MethodsFour full-thickness skin grafting procedures were performed on 12 adult Beagle dogs. The surgical technique is described in part I of this study.'* For the first 3 weeks after surgery, wire basket type muzzles were kept on the dogs, and the grafts were bandaged to prevent molestation. The following graft types were evaluated:1. Sheet-The sheet graft was not modified and served as a control.2. Drain-Continuous low level suction was provided by placing a fenestrated 19 gauge butterfly catheter* under the graft and attaching it to a 5 ml evacuated glass tube. t * Miniset Vein Infusion Set,

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

“…While some authors may elect to delay skin graft placement after tumour resection until the presence of granulation tissue in the wound bed (Siegfried and others ), this study supported previous statements and experimental studies that a delay is not necessary and full‐thickness meshed skin grafts could survive well on fresh surgical wounds (Pope , Bauer and Pope , Pope and Swaim ). The connective tissues of muscle, tendon, joint retinaculum and blood vessels in the distal extremities provide a viable bed for graft placement.…”

“…The graft of case 6 had the poorest hair growth only suffered partial thickness necrosis in 15% of the graft. Reduced hair regrowth could be due to overzealous removal of the subcutaneous tissue during graft preparation and reduced circulation during the revascularisation phase resulting in hair follicles being damaged (Pope and Swaim ). The exact causes of the tarso‐metatarsal periosteal lifting associated with the tumour excision and skin graft and the development of exuberant granulation tissue through the meshed graft in case 7 were not clear.…”

“…Muscle, fascia, perichondrium, periosteum, paratenon and perineurium have been stated to be good vascular beds for skin grafts (Swaim , Pope ,, Probst , Swaim ). Experimental studies in dogs have shown good skin graft survival on fresh surgical wounds on the trunk (Pope , Bauer and Pope , Pope and Swaim ). To the authors’ knowledge, there is only one clinical report in the literature in which two dogs received full‐thickness meshed free skin grafts on the antebrachium to cover fresh surgical wounds (Gregory and Gourley ).…”

Histomorphometric Analysis and Regional Variations of Full Thickness Skin Grafts in Dogs

“…Although it appears intuitive that increased dermal thickness may delay or permanently hamper graft acceptance, we are unaware of published research in dogs substantiating this statement. In animals, cosmetic appearance depends on the quantity and quality of hair regrowth and is usually acceptable if the graft is covered with hair . Mechanical damage to hair follicles during harvesting and preparation has not been evaluated.…”

Comparison of a new hydro-surgical technique to traditional methods for the preparation of full-thickness skin grafts from canine cadaveric skin and report of a single clinical case

“…In veterinary reconstructive surgery, the use of full-thickness free skin grafts is a versatile treatment option for difficult wounds (1)(2)(3). Full-thickness skin graft viability is highly variable, reported to be between 49-100% in several experimental and clini-cal studies in dogs (4)(5)(6)(7)(8)(9)(10). Important factors that aid in graft survival are eliminating shear forces, providing adequate drainage, preventing infection, supporting adequate blood supply and providing nutritional support to the patient (1,2).…”