Island skin graft associated with non-adherent mesh in a dog's pelvic limb
Autor(a) principal: | |
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Data de Publicação: | 2021 |
Outros Autores: | , , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Repositório Institucional da UNESP |
Texto Completo: | http://dx.doi.org/10.22456/1679-9216.106819 http://hdl.handle.net/11449/221811 |
Resumo: | Background: Large skin defects are caused by tumor excision, making appropriate reconstruction and complete healing of the lesion a challenge for surgeons. There are some difficulties in reaching these goals, especially in cases of surgical wound in the limbs, due to the scarce amount of skin and its reduced elasticity, which limit the possibility of flaps when compared to the head, neck, and trunk. This study reports a case of wound closure on the lateral skin in the femoral region of a dog's pelvic limb via island skin graft associated with the implantation of a non-adherent cellulose acetate mesh and intensive postoperative care. Case: An 8-year-old Rottweiler female dog was attended at Pontifical Catholic University of Paraná's Veterinary Clinic (CVE) in Curitiba, Paraná, presenting a tumor located laterocaudally to the right stifle joint. After preoperative examinations the patient underwent tumor surgery; however, two more surgical procedures were required due to suture dehiscence in the region, which resulted in increased wound size. At first, the wound was treated for granulation tissue to be formed. Subsequently, the island skin grafting technique was chosen to close the wound, associated with the implantation of a non-adherent cellulose acetate mesh imbibed with petrolatum emulsion to keep the grafted fragments in place. The mesh was fixed in a simple interrupted suture pattern using 2-0 nylon thread. The lateral regions of the chest and abdomen were chosen as donor skin beds due to their large dimensions, skin elasticity, and ease in defect reconstruction. The fragments were obtained using a 10-mm biopsy punch and scalpel, and the defects were sutured in a simple interrupted pattern using 2-0 nylon thread. The patient remained hospitalized for movement restriction and postoperative monitoring for 72 h, and the bandage remained untouched during this time interval. Thereafter, the patient was discharged and it was recommended to clean the wound with jets of 0.9% saline using a 40 × 12 needle attached to a 20 mL syringe, from a distance of 10 cm from the wound. The dressings were changed every 48 h to maintain minimum contact with the wound; however, still keeping it clean to optimize healing. Fourteen days postoperatively, the sutures as well as the non-adherent mesh were removed from the donor beds. The dressing was changed and the lesion was cleaned every 24 h because the fixation between the receptor bed and the implanted tissue was considered good. After approximately 80 days, complete epithelialization of the wound was observed. Discussion: Closing of large skin defects in the limbs is challenging due to the impossibility of using other reconstructive surgery techniques, which have limited use because of the extension of the lesion. However, island skin grafting can be considered despite its slower skin healing process than that of skin flaps. Specific management is required for the successful execution of this technique, and in the present case, the application of the non-adherent mesh after island skin grafting helped in the immobilization and better adhesion of the fragments to the receiving bed. Thus, it was demonstrated that in-depth knowledge of reconstructive surgery and the surgeon's expertise favor the emergence of ideas and more effective techniques that ensure success of the surgical procedure by avoiding complications and improving the patients' quality of life. |
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Island skin graft associated with non-adherent mesh in a dog's pelvic limbEnxerto cutâneo em semeadura associado à malha naõ aderente em membro pélvico de um caõOncological surgeryReconstructive surgeryScarringSkin graftWoundBackground: Large skin defects are caused by tumor excision, making appropriate reconstruction and complete healing of the lesion a challenge for surgeons. There are some difficulties in reaching these goals, especially in cases of surgical wound in the limbs, due to the scarce amount of skin and its reduced elasticity, which limit the possibility of flaps when compared to the head, neck, and trunk. This study reports a case of wound closure on the lateral skin in the femoral region of a dog's pelvic limb via island skin graft associated with the implantation of a non-adherent cellulose acetate mesh and intensive postoperative care. Case: An 8-year-old Rottweiler female dog was attended at Pontifical Catholic University of Paraná's Veterinary Clinic (CVE) in Curitiba, Paraná, presenting a tumor located laterocaudally to the right stifle joint. After preoperative examinations the patient underwent tumor surgery; however, two more surgical procedures were required due to suture dehiscence in the region, which resulted in increased wound size. At first, the wound was treated for granulation tissue to be formed. Subsequently, the island skin grafting technique was chosen to close the wound, associated with the implantation of a non-adherent cellulose acetate mesh imbibed with petrolatum emulsion to keep the grafted fragments in place. The mesh was fixed in a simple interrupted suture pattern using 2-0 nylon thread. The lateral regions of the chest and abdomen were chosen as donor skin beds due to their large dimensions, skin elasticity, and ease in defect reconstruction. The fragments were obtained using a 10-mm biopsy punch and scalpel, and the defects were sutured in a simple interrupted pattern using 2-0 nylon thread. The patient remained hospitalized for movement restriction and postoperative monitoring for 72 h, and the bandage remained untouched during this time interval. Thereafter, the patient was discharged and it was recommended to clean the wound with jets of 0.9% saline using a 40 × 12 needle attached to a 20 mL syringe, from a distance of 10 cm from the wound. The dressings were changed every 48 h to maintain minimum contact with the wound; however, still keeping it clean to optimize healing. Fourteen days postoperatively, the sutures as well as the non-adherent mesh were removed from the donor beds. The dressing was changed and the lesion was cleaned every 24 h because the fixation between the receptor bed and the implanted tissue was considered good. After approximately 80 days, complete epithelialization of the wound was observed. Discussion: Closing of large skin defects in the limbs is challenging due to the impossibility of using other reconstructive surgery techniques, which have limited use because of the extension of the lesion. However, island skin grafting can be considered despite its slower skin healing process than that of skin flaps. Specific management is required for the successful execution of this technique, and in the present case, the application of the non-adherent mesh after island skin grafting helped in the immobilization and better adhesion of the fragments to the receiving bed. Thus, it was demonstrated that in-depth knowledge of reconstructive surgery and the surgeon's expertise favor the emergence of ideas and more effective techniques that ensure success of the surgical procedure by avoiding complications and improving the patients' quality of life.Programa de Pós-Graduacąõ em Oncologia ANCLIVEPA-SP, SPClínica Veterinária Escola (CVE) Pontifícia Universidade Católica Do Paraná (PUCPR), PRHosp. Veterinario Governador Laudo Natel (HV)-Faculdade de Ciencias Agrarias e Veterinarias (FCAV), SPANCLIVEPA-SPPontifícia Universidade Católica Do Paraná (PUCPR)Hosp. Veterinario Governador Laudo Natel (HV)-Faculdade de Ciencias Agrarias e Veterinarias (FCAV)De Lima Queiroz, Thayana NeivaGermano, Petra CavalcantiMagrin, Milena GiovanaCastro, Jorge Luiz Costa2022-04-28T19:40:46Z2022-04-28T19:40:46Z2021-01-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlehttp://dx.doi.org/10.22456/1679-9216.106819Acta Scientiae Veterinariae, v. 49.1679-92161678-0345http://hdl.handle.net/11449/22181110.22456/1679-9216.1068192-s2.0-85108314876Scopusreponame:Repositório Institucional da UNESPinstname:Universidade Estadual Paulista (UNESP)instacron:UNESPporActa Scientiae Veterinariaeinfo:eu-repo/semantics/openAccess2022-04-28T19:40:46Zoai:repositorio.unesp.br:11449/221811Repositório InstitucionalPUBhttp://repositorio.unesp.br/oai/requestopendoar:29462024-08-05T20:28:11.171695Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP)false |
dc.title.none.fl_str_mv |
Island skin graft associated with non-adherent mesh in a dog's pelvic limb Enxerto cutâneo em semeadura associado à malha naõ aderente em membro pélvico de um caõ |
title |
Island skin graft associated with non-adherent mesh in a dog's pelvic limb |
spellingShingle |
Island skin graft associated with non-adherent mesh in a dog's pelvic limb De Lima Queiroz, Thayana Neiva Oncological surgery Reconstructive surgery Scarring Skin graft Wound |
title_short |
Island skin graft associated with non-adherent mesh in a dog's pelvic limb |
title_full |
Island skin graft associated with non-adherent mesh in a dog's pelvic limb |
title_fullStr |
Island skin graft associated with non-adherent mesh in a dog's pelvic limb |
title_full_unstemmed |
Island skin graft associated with non-adherent mesh in a dog's pelvic limb |
title_sort |
Island skin graft associated with non-adherent mesh in a dog's pelvic limb |
author |
De Lima Queiroz, Thayana Neiva |
author_facet |
De Lima Queiroz, Thayana Neiva Germano, Petra Cavalcanti Magrin, Milena Giovana Castro, Jorge Luiz Costa |
author_role |
author |
author2 |
Germano, Petra Cavalcanti Magrin, Milena Giovana Castro, Jorge Luiz Costa |
author2_role |
author author author |
dc.contributor.none.fl_str_mv |
ANCLIVEPA-SP Pontifícia Universidade Católica Do Paraná (PUCPR) Hosp. Veterinario Governador Laudo Natel (HV)-Faculdade de Ciencias Agrarias e Veterinarias (FCAV) |
dc.contributor.author.fl_str_mv |
De Lima Queiroz, Thayana Neiva Germano, Petra Cavalcanti Magrin, Milena Giovana Castro, Jorge Luiz Costa |
dc.subject.por.fl_str_mv |
Oncological surgery Reconstructive surgery Scarring Skin graft Wound |
topic |
Oncological surgery Reconstructive surgery Scarring Skin graft Wound |
description |
Background: Large skin defects are caused by tumor excision, making appropriate reconstruction and complete healing of the lesion a challenge for surgeons. There are some difficulties in reaching these goals, especially in cases of surgical wound in the limbs, due to the scarce amount of skin and its reduced elasticity, which limit the possibility of flaps when compared to the head, neck, and trunk. This study reports a case of wound closure on the lateral skin in the femoral region of a dog's pelvic limb via island skin graft associated with the implantation of a non-adherent cellulose acetate mesh and intensive postoperative care. Case: An 8-year-old Rottweiler female dog was attended at Pontifical Catholic University of Paraná's Veterinary Clinic (CVE) in Curitiba, Paraná, presenting a tumor located laterocaudally to the right stifle joint. After preoperative examinations the patient underwent tumor surgery; however, two more surgical procedures were required due to suture dehiscence in the region, which resulted in increased wound size. At first, the wound was treated for granulation tissue to be formed. Subsequently, the island skin grafting technique was chosen to close the wound, associated with the implantation of a non-adherent cellulose acetate mesh imbibed with petrolatum emulsion to keep the grafted fragments in place. The mesh was fixed in a simple interrupted suture pattern using 2-0 nylon thread. The lateral regions of the chest and abdomen were chosen as donor skin beds due to their large dimensions, skin elasticity, and ease in defect reconstruction. The fragments were obtained using a 10-mm biopsy punch and scalpel, and the defects were sutured in a simple interrupted pattern using 2-0 nylon thread. The patient remained hospitalized for movement restriction and postoperative monitoring for 72 h, and the bandage remained untouched during this time interval. Thereafter, the patient was discharged and it was recommended to clean the wound with jets of 0.9% saline using a 40 × 12 needle attached to a 20 mL syringe, from a distance of 10 cm from the wound. The dressings were changed every 48 h to maintain minimum contact with the wound; however, still keeping it clean to optimize healing. Fourteen days postoperatively, the sutures as well as the non-adherent mesh were removed from the donor beds. The dressing was changed and the lesion was cleaned every 24 h because the fixation between the receptor bed and the implanted tissue was considered good. After approximately 80 days, complete epithelialization of the wound was observed. Discussion: Closing of large skin defects in the limbs is challenging due to the impossibility of using other reconstructive surgery techniques, which have limited use because of the extension of the lesion. However, island skin grafting can be considered despite its slower skin healing process than that of skin flaps. Specific management is required for the successful execution of this technique, and in the present case, the application of the non-adherent mesh after island skin grafting helped in the immobilization and better adhesion of the fragments to the receiving bed. Thus, it was demonstrated that in-depth knowledge of reconstructive surgery and the surgeon's expertise favor the emergence of ideas and more effective techniques that ensure success of the surgical procedure by avoiding complications and improving the patients' quality of life. |
publishDate |
2021 |
dc.date.none.fl_str_mv |
2021-01-01 2022-04-28T19:40:46Z 2022-04-28T19:40:46Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://dx.doi.org/10.22456/1679-9216.106819 Acta Scientiae Veterinariae, v. 49. 1679-9216 1678-0345 http://hdl.handle.net/11449/221811 10.22456/1679-9216.106819 2-s2.0-85108314876 |
url |
http://dx.doi.org/10.22456/1679-9216.106819 http://hdl.handle.net/11449/221811 |
identifier_str_mv |
Acta Scientiae Veterinariae, v. 49. 1679-9216 1678-0345 10.22456/1679-9216.106819 2-s2.0-85108314876 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.none.fl_str_mv |
Acta Scientiae Veterinariae |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.source.none.fl_str_mv |
Scopus reponame:Repositório Institucional da UNESP instname:Universidade Estadual Paulista (UNESP) instacron:UNESP |
instname_str |
Universidade Estadual Paulista (UNESP) |
instacron_str |
UNESP |
institution |
UNESP |
reponame_str |
Repositório Institucional da UNESP |
collection |
Repositório Institucional da UNESP |
repository.name.fl_str_mv |
Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP) |
repository.mail.fl_str_mv |
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1808129206396125184 |