Lesão traumática facial em cão - reconstrução cirúrgica com retalho de transposição rotacional / Facial traumatic injury in a dog - surgical reconstruction with rotational transposition flap

Background: Bite injuries are commonly found in small animal clinics, especially in male dogs, due to their habits of fighting and territorial disputes. In general, the lesions are treated with the use of compresses and bandages, however, it is extremely important to carefully evaluate the site, in order to carry out the appropriate treatment. In cases of tissue loss, an increasingly used practice is reconstructive surgery, which launches alternatives for treatment through flaps and skin grafts, promoting healing and satisfactory aesthetic repair. This report describes the case of a dog with a facial bite, treated with reconstructive surgery. Case: A 5-year-old male mixed-breed dog, with a body mass of 5 kg, was treated and submitted to a physical examination, due to the owner's complaint that he had been attacked by another dog, causing a bite on the face. On physical examination, the animal showed normal vital parameters, except for mild hyperthermia due to rectal temperature (39.5°C). On the face, it was possible to observe a lacerative lesion in the temporomandibular and masseteric regions, with loss of skin and muscle, in addition to having an aspect of infection and necrosis. To describe the hematological profile, a blood count was performed, showing no changes. In the biochemical tests, the present alteration was a slight increase in Alkaline Phosphatase (393.8 IU/L). Surgical treatment was indicated through facial reconstruction with a skin graft. After performing the antisepsis, the lesion was debrided, the edges were regularized and the injured tissue was curetted. For reconstruction of the defect, we used a flap obtained through a perpendicular incision at the base of the ear, in a caudal direction, and this flap was pulled and transposed over the wound. Flap synthesis was performed with 3-0 nylon thread. After surgery, a compressive bandage was performed, which was removed after 24 h. It was indicated to avoid exertion in the area and to return in 10 days for the evaluation of the surgery and removal of the stitches. Discussion: Traumatic injuries in animals are being increasingly reported, with male and non-neutered dogs being the most prevalent patients. This report is in line with other studies, with the patient's profile being a male dog, with an average age, in line with the literature. In general, in certain types of wounds, the affected animals can develop sepsis and even progress to death, however, in this case the patient did not show changes in vital parameters and in hematological tests. Reconstructive surgeries are performed with the aim of correcting skin defects and knowledge of the available techniques is important. It is also necessary to carry out a good planning, in order to avoid complications in the trans and postoperative period. In the present case, we chose to use a flap obtained through an incision perpendicular to the base of the ear, transposing it over the wound, in addition to relieving tissue tension through skin divulsion, increasing its elastic potential. The use of bandages is considered extremely important for the success of the surgical procedure, as it provides an efficient barrier against infections, trauma and adhesions. However, we emphasize the need to use ointments, gauzes and bandages concomitantly, in order to have the desired success in the postoperative period. In addition to proper surgical techniques, pain management and infection control are important for patient recovery. It is important to use non-steroidal anti-inflammatory drugs and opioids to obtain analgesia, in addition to antibiotic therapy before and after surgery. The reported case demonstrated that lesions in dogs with skin loss can be reconstructed using skin flaps, with an excellent recovery and good prognosis, as was the case with the patient in this report.

Closure of defects in a geometric figure pattern associated with tumescent anesthesia with lidocaine in rabbits (Oryctolagus cuniculus) / Fechamento de defeitos em padrão de figura geométrica associado ao emprego de anestesia por tumescência com lidocaína em coelhos (Oryctolagus cuniculus)

The use of tumescent anesthesia with lidocaine can provide better intra- and postoperative analgesia that would benefit extensive reconstructive surgery. However, lidocaine can interfere with the healing process. Therefore, this study aimed to assess the local interference of the healing of induced and closed skin defects in a geometric pattern associated with the use of tumescent anesthesia with lidocaine in rabbits. Furthermore, we assessed its influence on cardiorespiratory parameters and postoperative analgesia. This study included 27 rabbits divided into three groups: GC (without the use of tumescence), GS (use of tumescence with 0.9% NaCl solution), and GL (use of tumescent anesthesia with lidocaine). There was no statistically significant intergroup difference in any stage of the wound healing process on macroscopic evaluations, in the angiogenesis process, or in the process of collagenization and fibroblast deposition. There were significant differences in heart rate (lower in GL), respiratory rate (higher in GC), mean arterial pressure (higher in GL), and expired concentration of isoflurane (lower in GL). There was no significant intergroup difference in the von Frey filament test or the visual analog scale score used to evaluate postoperative analgesia. We concluded that tumescent anesthesia with lidocaine does not impair postoperative tissue repair. Its use features benefits such as reducing the volume of inhaled anesthetic, maintaining the anesthesia plan, stable heart and respiratory rates, and lower hypotension during the surgical procedure.

O uso da anestesia por tumescência com lidocaína pode proporcionar melhor analgesia transoperatória e pós-operatória, o que seria um benefício em cirurgias reconstrutivas extensas. Entretanto, a lidocaína pode interferir na cicatrização. Diante disso, delineou-se um estudo a fim de avaliar a interferência local da cicatrização de defeitos cutâneos induzidos e fechados em padrão de figura geométrica, associado ao emprego de anestesia por tumescência com lidocaína em coelhos. Ademais, avaliar sua influência em parâmetros cardiorrespiratórios e na analgesia pós-operatória. Foi realizado um estudo com 27 coelhos, separados em três grupos, compreendidos em GC (sem o emprego de tumescência), GS (emprego de tumescência com solução NaCl 0.9%) e GL (emprego de anestesia por tumescência com lidocaína). Não houve diferença estatística em nenhuma etapa do processo cicatricial da ferida entre os grupos, tampouco nas avaliações macroscópicas, e no processo de angiogênese, ou ainda no processo de colagenização e deposição de fibroblastos. Houve diferença significativa na frequência cardíaca (menor no GL) e na respiratória (maior no GC), na pressão arterial média (maior no GL) e na concentração expirada de isoflurano (menor no GL). Não houve diferença significativa entre os grupos no teste de filamentos de von Frey e na Escala Visual Analógica, utilizados para avaliar a analgesia pós-operatória. Conclui-se que anestesia por tumescência com lidocaína não prejudica a regeneração tecidual após a cirurgia. O seu uso oferece benefícios como a diminuição do volume de anestésico inalatório, manutenção do plano anestésico, estabilidade das frequências cardíaca e respiratória, além de menor hipotensão durante o procedimento cirúrgico.

Reconstrução prepucial com uso de enxerto combinado em cães / Preputial reconstruction combined with graft in dogs

Background: Preputial injuries are significant in the clinical routine. Traumas, conditions, and mass excision result in extensive and full-thickness defects that lead to chronic penile exposure and consequential injuries. Severe injuries may require preputial reconstructive surgery to restore function and aesthetics. The objective is to report the use of the preputial reconstruction technique using the caudal superficial epigastric axial standard flap associated with a single-stage, full-thickness oral mucosa graft in 3 dogs where the loss of the prepuce was significant. Cases: Three dogs were admitted to the Veterinary Teaching Hospital of UFMT with preputial lesions of different etiologies. All cases were referred for preventive reconstruction using a flap in the caudal axial epigastric pattern associated with a single-stage oral mucosa graft. In the 3 reported cases, changes that compromised surgical success, such as suture dehiscence, necrosis, or infection, were not observed during hospitalization. Cutaneous stitch dehiscence, however, was observed in all 3 cases. Dog 1. A small point of dehiscence and tissue necrosis was found and treated with chemical debridement and healed by second intention, which proved to be sufficient on the 30th day. Dog 2. A half-moon rotation flap was performed, which closed the defect. Dog 3. A new procedure using the reporting theme technique was necessary in order to cover the cranial portion of the foreskin. The dehiscence present in dogs 2 and 3 was significant. Flap retraction was observed in all 3 cases. In dogs 1 and 3, the retraction was slight, and the exposure of a small portion of the penile glans were observed, showing no changes that required intervention. In dog 2, retraction was important, leading to partial stenosis of the preputial ostium. A larger ostium was obtained by suturing the mucosa to the edge of the wedge. Considering the possibility of adhesion formation, "captons" were made in sterile silicone tubes, and sutures were placed in the dorsal and ventral aspects to prevent adherence of the oral mucosa graft located on the inside of the new foreskin. The captons were removed on the tenth post-operative day, revealing a good opening of the preputial orifice and adequate penile exposure. Discussion: The absence of a foreskin caused by trauma or surgical excision leads to chronic penile exposure, dryness, and ulcerations. The simple covering of the skin with an axial-type flap of the caudal superficial epigastric region tends to fail since only the graft edges are sutured into the abdominal skin. In these circumstances, the subcutaneous region on the penis is exposed and comes in direct contact with urine and the penile mucosa, causing the flap skin to grow to exacerbated retraction. The transplantation of a free-lip mucosa graft allows the subcutaneous region of the transposed skin flap to create adhesions in the fenestrated regions of the lip tissue through the formation of granulation tissue buds, which is performed in a single stage. The permanence of the penis protects the lower urinary system from the occurrence of infections relative to what is normally observed in cases where partial or total penile amputation is practiced in combination with adjunctive scrotal urethrostomy. Given the observations of the 3 cases described here, the technique of pre-facial reconstruction with an axial skin flap of the caudal superficial epigastric region, combined with free-labial mucosa graft, was found to be feasible for the single-stage foreskin technique, but that paraphimosis remanagement may be necessary when cutaneous portions of the penile skin caudal to the glans are removed.

Estabilização zigomática e retalho de avanço facial lateral em canino filhote / Zygomatic stabilization and lateral facial advancement flap in a puppy dog

O trauma é frequentemente relatado na rotina clínica de pequenos animais, podendo gerar fraturas de componentes ósseos e lesões de tecidos moles adjacentes. No presente trabalho, objetivou-se relatar o caso de um canino, macho, sem raça definida, de sete meses de idade, vítima de trauma craniomaxilofacial decorrente de mordedura, diagnosticado com fratura e deslocamento de osso zigomático, além de importante laceração de pele. O tratamento estabelecido baseou-se no debridamento da ferida, estabilização cirúrgica de arco zigomático com fios de Nylon e na sutura dos ferimentos de pele causados. Em um segundo tempo cirúrgico, foi realizada enucleação e recobrimento do defeito na órbita com malha cirúrgica de polipropileno, além de remoção de tecido exuberante e confecção de retalho subdérmico de avanço facial lateral para recobrimento do defeito cutâneo. A complicação evidenciada na primeira intervenção cirúrgica foi a deiscência das suturas de pele, enquanto no segundo tempo cirúrgico, não houve sinais de complicações. No pós-operatório, o paciente apresentou evolução clínica satisfatória, recebendo alta médica 21 dias após o segundo procedimento cirúrgico realizado. Tendo em vista a adequada evolução clínica, bem como os reduzidos efeitos colaterais, sugere-se que a conduta clínica e técnicas cirúrgicas adotadas para tratamento do paciente em questão foram efetivas.

Trauma is frequently reported in the small animal clinics, and can lead to fractures of cranial bone components and injuries to the adjacent soft tissues. In the present study, the objective was to report the case of a seven-month-old male mongrel dog, that had a craniomaxillofacial trauma resulting from a bite, characterized by zygomatic bone fracture and displacement, in addition to a major skin laceration. The stablished treatment was based on wound debridement, surgical stabilization of the zygomatic arch with nylon threads and in the suturing of skin wounds. In a second surgical procedure, enucleation was performed and a surgical polypropylene mesh was applied to cover the orbital defect, exuberant tissue was removed and a subdermal advancement flap was used to cover the skin defect. The complication observed in the first surgical intervention was dehiscence of the skin sutures, while in the second surgical procedure, there were no signs of complications. Postoperatively, the patient had a satisfactory clinical recovery, being discharged 21 days after the second surgical procedure. Considering the adequate clinical evolution and the reduced complications, it issuggestedthat the clinical conduct and surgical techniques adopted for the treatment of the patient in question were effective.

Coloboma eyelid in cats - treatment with carbon dioxide cryosurgery

Background: Eyelid colobomas are congenital and developmental disorders. Generally, they affect the temporal portion of the upper eyelids of cats, bilaterally. This ocular defect is accompanied by trichiasis associated with pain and ulcerative keratitis. Any breed can be affected and it has been reported in Domestic Shorthair, Persian, Burmese, Mongrel cats and captive felids. The objective of this case report is to describe the technique of dioxide carbon cryosurgery for the treatment of eyelid coloboma in felines. Cases: Seven mongrel cats (14 eyes) with bilateral eyelid coloboma were included in this study, 5 females and 2 males, with a median age of 5 months (range 6-8 months). The patients presented with blepharospasm, bilateral mucopurulent ocular discharge and eyelid coloboma extension of 30-50% in the upper eyelid, resulting in severe trichiasis of both eyes. In 5 cats, 1 or both eyes were diagnosed with keratitis and superficial corneal ulcers. Surgical treatment with general anaesthesia was applied. The pre anaesthesia protocol included acepromazine 0.05 mg/kg with methadone 0.2 mg/kg, followed by intravenous propofol and maintenance with isoflurane and oxygen. An ophthalmological cryocautery unit was utilised with carbon dioxide as the cryogenic agent and a retinal cryoprobe of 3.2 mm diameter tip, reaching -50ºC for the procedure. The method used was a double cycle of freezing and thawing for 60 s in the margins of eyelid agenesis. Epilation of hairs was made after freezing with eyelash tweezers. Immediately after the surgical procedure, an Elizabethan collar was placed to safeguard the area and anti-inflammatory therapy with meloxicam 0.1 mg/kg once daily for 3 days was prescribed. Antibiotic ointment every 6 h (chloramphenicol and associations) was also prescribed for topical application. Two weeks post-operatively, hyperaemia, oedema and skin wounds at the margins were observed. After 30 days these clinical signs were minimal. No signs of pain were observed post-operatively. The follow-up was 90 days and the trichiasis was resolved in all cats. Discussion: Usually, young cats are affected with eyelid colobomas. The age of the patients in this study was between 6-8 months. Eyelid colobomas are repaired with a variety of blepharoplastic procedures and the choice depends on the size and position of the defect. Generally, larger defects require more extensive reconstructive procedures. All techniques can have post-operative complications. Suture dehiscence, skin flap necrosis and facial deformation can occur with traditional surgical techniques. Furthermore, posterior hair growth in the margins can lead to new trichiasis. Cryosurgery was chosen and performed as the temperature of -20°C is sufficient to destroy hair follicles, without surgical incisions, avoiding scar formation. Hence, sutures are not necessary in cryosurgery procedures. Carbon dioxide is a good cryogenic agent for the purpose of this procedure. In the cases described, no recurrence of hair growth was observed in the follow-up period of 90 days. Nevertheless, a good aesthetic appearance was maintained. Therefore, the use of carbon dioxide cryosurgery is an effective and safe alternative for treatment of eyelid coloboma in cats. To our knowledge, no paper has described the use of carbon dioxide cryosurgery for the correction of palpebral agenesis in felines and other species as a single treatment. This technique is easy to perform, has good aesthetic and functional results and can be considered a treatment option for this congenital condition.

Facial restoration after trauma - nasolabial in monkey bugio - Alouatta caraya (Humboldt, 1812) - first case report / [Restauração facial pós trauma nasolabial em macaco bugio - Alouatta caraya (Humboldt, 1812) - relato de caso]

In the last decades in the State of Mato Grosso do Sul - Brazil, the reduction in the preservation of areas due to the degradation of the biome and destruction of the natural environment has caused animals, mainly in the order of non-human primates, to come closer to towns and highways, increasing the number of accidents and in some cases, deaths. New surgical techniques have been developed that favor these species as explained in this report. The howler monkey patient was traumatized in the facial region damaging important vital structures such as facial muscle groups responsible for swallowing food, chewing, breathing, defense, and communication (vocalization and mimicry), in addition to the cartilaginous nasal structures. However, reconstructive facial surgical techniques, used on humans, showed satisfactory results from an anatomical, functional, and aesthetic point of view in howler monkey, with acceptance of the animal with a safe postoperative period for a full recovery of the primate patient.(AU)

Nas últimas décadas, no estado do Mato Grosso do Sul - Brasil, a redução de áreas preservadas pela degradação de biomas e pela destruição de habitat naturais tem favorecido a aproximação de animais - muitos desses, primatas não humanos - em cidades e rodovias, aumentando o número de acidentes e, em alguns casos, de mortes. Novas técnicas cirúrgicas têm sido desenvolvidas, favorecendo essas espécies, como reportado neste trabalho. O paciente macaco bugio foi traumatizado em região facial, envolvendo importantes estruturas vitais, como grupos musculares faciais responsáveis pela apreensão alimentar, mastigação, respiração, defesa e comunicação (vocalização e mímicas), além das estruturas cartilaginosas nasais. No entanto, técnicas cirúrgicas reconstrutivas em face aplicadas e descritas em humanos apresentaram resultados satisfatórios dos pontos de vista anatômico, fisiológico e visual nos macacos bugio, com aceitação deles diante do estresse, com pós-operatório seguro, resultando na reabilitação do paciente primata.(AU)

Retalho de avanço para correção de hemangiossarcoma em região peniana de cão: relato de caso / Advancement flap in dog penile region due to cutaneous hemangiosarcoma: case report / Uso de venta al por menor avanzada en la región penial del perro debido al hemangiosarcoma cutáneo: informe de caso

O uso de técnicas de cirurgia reconstrutiva é de grande importância quando há perda de uma ampla quantidade de tecido cutâneo. O objetivo deste trabalho é relatar a utilização da técnica de retalho de avanço pediculado em decorrência de extensa ausência de tecido cutâneo resultante da exérese de neoplasia na região peniana de um cão. O presente estudo relata o caso de um cão da raça American Pitbull Terrier, macho castrado, com sete anos de idade, com histórico de neoplasia e aumento de nódulo na região peniana. Após avaliação clínica do animal, achou-se por bem o tratamento por meio da remoção cirúrgica do neoplasma. Durante o procedimento cirúrgico constatou-se que seria necessário o emprego de um retalho de avanço pediculado para fechamento da ferida ocasionada pela remoção da neoplasia. Para diminuir a tensão e os riscos de complicações no retalho, foi realizada uma "walking suture" no subcutâneo, técnicas essas que garantiram uma cicatrização com aspecto estético e funcional satisfatório com o mínimo de tensão.(AU)

The use of reconstructive surgery techniques is of great importance when there is loss of a large amount of cutaneous tissue. The objective of this study is to report the use of pedicle flap technique as a result of extensive absence of cutaneous tissue resulting from the excision of neoplasia in the penile dog region. The present study reports the case of a seven year old male Pitbull Terrier, with a history of neoplasia and nodule enlargement in the penile region. After the clinical evaluation of the animal, the treatment by the surgical removal of the neoplasm was considered good. During the surgical procedure, it was found that a pedicle flap should be used to close the wound caused by removal of the neoplasia. To reduce tension and risk of complications in the flap, a walking suture was performed on the subcutaneous tissue, which ensure healing with aesthetic and functional appearance with minimal tension.(AU)

El uso de técnicas de cirugía reconstructiva es de gran importancia cuando se pierde una gran cantidad de tejido de la piel. El objetivo de este estudio es informar el uso de la técnica de colgajo de avance pediculado debido a la extensa ausencia de tejido de la piel como resultado de la escisión de la neoplasia en la región del pene del perro. El presente estudio informa el caso de un Pitbull Terrier americano de siete años, un hombre castrado, con antecedentes de neoplasia y un nódulo agrandado en la región del pene. Después de la evaluación clínica del animal, se consideró el tratamiento mediante la extirpación quirúrgica de la neoplasia. Durante el procedimiento quirúrgico, se descubrió que el uso de un colgajo de avance pediculado sería necesario para cerrar la herida causada por la extirpación de la neoplasia. Para reducir la tensión y el riesgo de complicaciones en el colgajo, se realizó una sutura ambulante en el tejido subcutáneo, técnicas que aseguraron la curación con un aspecto estético y funcional satisfactorio con una tensión mínima.(AU)

Retalho de avanço para correção de hemangiossarcoma em região peniana de cão: relato de caso / Advancement flap in dog penile region due to cutaneous hemangiosarcoma: case report / Uso de venta al por menor avanzada en la región penial del perro debido al hemangiosarcoma cutáneo: informe de caso

O uso de técnicas de cirurgia reconstrutiva é de grande importância quando há perda de uma ampla quantidade de tecido cutâneo. O objetivo deste trabalho é relatar a utilização da técnica de retalho de avanço pediculado em decorrência de extensa ausência de tecido cutâneo resultante da exérese de neoplasia na região peniana de um cão. O presente estudo relata o caso de um cão da raça American Pitbull Terrier, macho castrado, com sete anos de idade, com histórico de neoplasia e aumento de nódulo na região peniana. Após avaliação clínica do animal, achou-se por bem o tratamento por meio da remoção cirúrgica do neoplasma. Durante o procedimento cirúrgico constatou-se que seria necessário o emprego de um retalho de avanço pediculado para fechamento da ferida ocasionada pela remoção da neoplasia. Para diminuir a tensão e os riscos de complicações no retalho, foi realizada uma "walking suture" no subcutâneo, técnicas essas que garantiram uma cicatrização com aspecto estético e funcional satisfatório com o mínimo de tensão.(AU)

The use of reconstructive surgery techniques is of great importance when there is loss of a large amount of cutaneous tissue. The objective of this study is to report the use of pedicle flap technique as a result of extensive absence of cutaneous tissue resulting from the excision of neoplasia in the penile dog region. The present study reports the case of a seven year old male Pitbull Terrier, with a history of neoplasia and nodule enlargement in the penile region. After the clinical evaluation of the animal, the treatment by the surgical removal of the neoplasm was considered good. During the surgical procedure, it was found that a pedicle flap should be used to close the wound caused by removal of the neoplasia. To reduce tension and risk of complications in the flap, a walking suture was performed on the subcutaneous tissue, which ensure healing with aesthetic and functional appearance with minimal tension.(AU)

El uso de técnicas de cirugía reconstructiva es de gran importancia cuando se pierde una gran cantidad de tejido de la piel. El objetivo de este estudio es informar el uso de la técnica de colgajo de avance pediculado debido a la extensa ausencia de tejido de la piel como resultado de la escisión de la neoplasia en la región del pene del perro. El presente estudio informa el caso de un Pitbull Terrier americano de siete años, un hombre castrado, con antecedentes de neoplasia y un nódulo agrandado en la región del pene. Después de la evaluación clínica del animal, se consideró el tratamiento mediante la extirpación quirúrgica de la neoplasia. Durante el procedimiento quirúrgico, se descubrió que el uso de un colgajo de avance pediculado sería necesario para cerrar la herida causada por la extirpación de la neoplasia. Para reducir la tensión y el riesgo de complicaciones en el colgajo, se realizó una sutura ambulante en el tejido subcutáneo, técnicas que aseguraron la curación con un aspecto estético y funcional satisfactorio con una tensión mínima.(AU)

Terapia multimodal no tratamento de hemangiossarcoma cutâneo canino / Multimodal therapy in the treatment of cutaneous canine hemangiosarcoma

O hemangiossarcoma é uma neoplasia mesenquimal maligna de origem endotelial. Quando manifestada em região cutânea, os sinais clínicos estão ligados a variações hemostáticas, como petéquias e hemorragias. O diagnóstico definitivo é obtido por exame histopatológico. A conduta cirúrgica é a terapia de escolha, podendo ser necessária a realização de técnicas reconstrutivas a depender da localização da neoplasia. A quimioterapia adjuvante, metronômica ou convencional, pode ser empregada. Um canino, fêmea, sem raça definida, de oito anos de idade, atendido com um nódulo cutâneo em região ventro abdominal. O animal foi submetido a protocolo quimioterápico metronômico, devido à extensão do tumor que impedia a exérese cirúrgica em um primeiro momento. O tratamento levou à citorredução, viabilizando a exérese tumoral, desconsiderando as margens de segurança, em caráter paliativo. Após a cirurgia o protocolo quimioterápico foi retomado e mantido nos dois meses seguintes. O animal permaneceu livre da doença nos seis meses seguintes, realizando revisões periódicas. O presente trabalho relata a abordagem multimodal aplicada em um caso de hemangiossarcoma cutâneo, atingindo qualidade de vida e sobrevida satisfatórias.

Hemangiosarcoma is a malignant mesenchymal neoplasm of endothelial origin. When manifested in the cutaneous region, clinical signs are linked to hemostatic variations, such as petechiae and hemorrhages. The definitive diagnosis is obtained by histopathological examination. Surgical management is the therapy of choice, and reconstructive techniques may be necessary depending on the location of the neoplasia. Adjuvant chemotherapy, either metronomic or conventional, can be used. An eight-year-old female, mixed-breed canine was treated with a cutaneous nodule in the abdominal ventral region. The animal was submitted to a metronomic chemotherapy protocol, due to the extension of the tumor that prevented surgical excision at first. The treatment led to cytoreduction, making the tumor excision feasible, disregarding the safety margins, in a palliative character. After surgery, the chemotherapy protocol was resumed and maintained for the next two months. The animal remained free of the disease for the following six months, undergoing periodic reviews. The present work reports the multimodal approach applied in a case of cutaneous hemangiosarcoma, achieving satisfactory quality of life and survival.

Terapia multimodal no tratamento de hemangiossarcoma cutâneo canino / Multimodal therapy in the treatment of cutaneous canine hemangiosarcoma

O hemangiossarcoma é uma neoplasia mesenquimal maligna de origem endotelial. Quando manifestada em região cutânea, os sinais clínicos estão ligados a variações hemostáticas, como petéquias e hemorragias. O diagnóstico definitivo é obtido por exame histopatológico. A conduta cirúrgica é a terapia de escolha, podendo ser necessária a realização de técnicas reconstrutivas a depender da localização da neoplasia. A quimioterapia adjuvante, metronômica ou convencional, pode ser empregada. Um canino, fêmea, sem raça definida, de oito anos de idade, atendido com um nódulo cutâneo em região ventro abdominal. O animal foi submetido a protocolo quimioterápico metronômico, devido à extensão do tumor que impedia a exérese cirúrgica em um primeiro momento. O tratamento levou à citorredução, viabilizando a exérese tumoral, desconsiderando as margens de segurança, em caráter paliativo. Após a cirurgia o protocolo quimioterápico foi retomado e mantido nos dois meses seguintes. O animal permaneceu livre da doença nos seis meses seguintes, realizando revisões periódicas. O presente trabalho relata a abordagem multimodal aplicada em um caso de hemangiossarcoma cutâneo, atingindo qualidade de vida e sobrevida satisfatórias.(AU)

Hemangiosarcoma is a malignant mesenchymal neoplasm of endothelial origin. When manifested in the cutaneous region, clinical signs are linked to hemostatic variations, such as petechiae and hemorrhages. The definitive diagnosis is obtained by histopathological examination. Surgical management is the therapy of choice, and reconstructive techniques may be necessary depending on the location of the neoplasia. Adjuvant chemotherapy, either metronomic or conventional, can be used. An eight-year-old female, mixed-breed canine was treated with a cutaneous nodule in the abdominal ventral region. The animal was submitted to a metronomic chemotherapy protocol, due to the extension of the tumor that prevented surgical excision at first. The treatment led to cytoreduction, making the tumor excision feasible, disregarding the safety margins, in a palliative character. After surgery, the chemotherapy protocol was resumed and maintained for the next two months. The animal remained free of the disease for the following six months, undergoing periodic reviews. The present work reports the multimodal approach applied in a case of cutaneous hemangiosarcoma, achieving satisfactory quality of life and survival.(AU)

Use of thermography in skin grafts after the application of therapeutic ultrasound in Wistar rats

Purpose To analyze changes in the thermal pattern in the skin graft receptor bed, after the use of therapeutic ultrasound through the thermographic images. Methods Eighteen Rattus norvegicus albinus Wistar, separated into two groups: GST groups (without tumor and without treatment with ultrasound) and GT (with tumor and treatment with ultrasound). In the GT group, induction of carcinogenesis was performed by single intradermal application of 0.05 ml DMBA at 0.5%, diluted in acetone. Subsequently, a technique of reconstructive grafting surgery of the mesh type was performed in both groups and treatment with therapeutic ultrasound was performed in the GT group the alternate day protocol at 3, 6, 10 and 15 days after the procedure. The thermographic evaluation occurred on days 3, 6, 10 and 15 after the grafting. Results There was a significant difference between the statistical evaluation of the temperature of the control group when compared to the treated group, on the different evaluation days (p <0.0001). Conclusion The thermographic analysis of the images was effective in evaluating the healing process, being the use of thermography feasible to evaluate changes in the thermal standard in the surgical bed, besides the beneficial effects of the US.(AU)

Ampliação de margens em cão com mastocitoma cutâneo: relato de caso / Margins enlargement in dog for cutaneous mastocytoma: case report

Objetiva-se relatar a reintervenção cirúrgica para ampliação de margens em um paciente diagnosticado com mastocitoma cutâneo. Um canino, macho, Bulldog Francês, com 7 anos foi atendido com histórico de retirada de nódulo cutâneo em região abdominal há 15 dias, com diagnóstico histopatológico compatível com mastocitoma grau I e margens cirúrgicas comprometidas. Optou-se então pela realização de um segundo procedimento cirúrgico para ampliação das margens de segurança, o qual foi precedido por planejamento de 5 cm de margens cutâneas e uma camada de fáscia e um plano muscular como margem profunda, juntamente com a linfadenectomia inguinal. Durante o procedimento, foi possível a síntese sem a necessidade do uso de técnicas reconstrutivas, a partir da divulsão do subcutâneo e da utilização do padrão Walking Suture. Não houve intercorrências transoperatórias, e a formação de hematoma foi a única complicação pósoperatória observada. O material foi enviado para análise histopatológica, confirmando mastocitoma cutâneo baixo grau/grau I com margens livres, sem evidências de metástase em linfonodo. Dessa forma, não foram instituídas terapias adjuvantes, e após 320 dias pós-operatórios, o paciente apresentava-se em ótimo estado geral, sem evidências de recidiva ou metástases à distância na radiografia torácica e ultrassonografia abdominal. Conclui-se que a reintervenção cirúrgica pode ser uma alternativa para o tratamento do mastocitoma baixo grau/grau I com margens comprometidas, sendo o diagnóstico histopatológico e o planejamento cirúrgico essenciais para redução de complicações trans e pósoperatórias, aumentando as chances de sucesso e cura do paciente.

The objective is to report the surgical reintervention for enlarging margins in a patient diagnosed with cutaneous mast cell tumor. A canine, male, French Bulldog, 7 years old, was seen with a history of skin nodule removal in the abdominal region 15 days ago, with a histopathological diagnosis compatible with grade I mastocytoma and compromised surgical margins. Then, it was decided to perform a second surgical procedure to expand the safety margins, which was preceded by planning 5 cm of cutaneous margins and a layer of fascia and a muscular plane as a deep margin, in addition to inguinal lymphadenectomy. During the procedure, synthesis was possible without the use of reconstructive techniques, from the subcutaneous divulsion and the use of the Walking Suture pattern. There were no transoperative complications, and hematoma formation was the only postoperative complication observed. The material was sent for histopathological analysis, confirming low-grade cutaneous mastocytoma with free margins and no evidence of lymph node metastasis. Thus, adjuvant therapies were not instituted, and after 320 postoperative days, the patient was in excellent general condition, with no evidence of recurrence or distant metastases on chest radiography and abdominal ultrasound. It is concluded that surgical reintervention can be an alternative for the treatment of low-grade mastocytoma with compromised margins, and that histopathological diagnosis and surgical planning are essential to reduce trans and postoperative complications, increasing the chances of success and cure of the patient.

Ampliação de margens em cão com mastocitoma cutâneo: relato de caso / Margins enlargement in dog for cutaneous mastocytoma: case report

Objetiva-se relatar a reintervenção cirúrgica para ampliação de margens em um paciente diagnosticado com mastocitoma cutâneo. Um canino, macho, Bulldog Francês, com 7 anos foi atendido com histórico de retirada de nódulo cutâneo em região abdominal há 15 dias, com diagnóstico histopatológico compatível com mastocitoma grau I e margens cirúrgicas comprometidas. Optou-se então pela realização de um segundo procedimento cirúrgico para ampliação das margens de segurança, o qual foi precedido por planejamento de 5 cm de margens cutâneas e uma camada de fáscia e um plano muscular como margem profunda, juntamente com a linfadenectomia inguinal. Durante o procedimento, foi possível a síntese sem a necessidade do uso de técnicas reconstrutivas, a partir da divulsão do subcutâneo e da utilização do padrão Walking Suture. Não houve intercorrências transoperatórias, e a formação de hematoma foi a única complicação pósoperatória observada. O material foi enviado para análise histopatológica, confirmando mastocitoma cutâneo baixo grau/grau I com margens livres, sem evidências de metástase em linfonodo. Dessa forma, não foram instituídas terapias adjuvantes, e após 320 dias pós-operatórios, o paciente apresentava-se em ótimo estado geral, sem evidências de recidiva ou metástases à distância na radiografia torácica e ultrassonografia abdominal. Conclui-se que a reintervenção cirúrgica pode ser uma alternativa para o tratamento do mastocitoma baixo grau/grau I com margens comprometidas, sendo o diagnóstico histopatológico e o planejamento cirúrgico essenciais para redução de complicações trans e pósoperatórias, aumentando as chances de sucesso e cura do paciente.(AU)

The objective is to report the surgical reintervention for enlarging margins in a patient diagnosed with cutaneous mast cell tumor. A canine, male, French Bulldog, 7 years old, was seen with a history of skin nodule removal in the abdominal region 15 days ago, with a histopathological diagnosis compatible with grade I mastocytoma and compromised surgical margins. Then, it was decided to perform a second surgical procedure to expand the safety margins, which was preceded by planning 5 cm of cutaneous margins and a layer of fascia and a muscular plane as a deep margin, in addition to inguinal lymphadenectomy. During the procedure, synthesis was possible without the use of reconstructive techniques, from the subcutaneous divulsion and the use of the Walking Suture pattern. There were no transoperative complications, and hematoma formation was the only postoperative complication observed. The material was sent for histopathological analysis, confirming low-grade cutaneous mastocytoma with free margins and no evidence of lymph node metastasis. Thus, adjuvant therapies were not instituted, and after 320 postoperative days, the patient was in excellent general condition, with no evidence of recurrence or distant metastases on chest radiography and abdominal ultrasound. It is concluded that surgical reintervention can be an alternative for the treatment of low-grade mastocytoma with compromised margins, and that histopathological diagnosis and surgical planning are essential to reduce trans and postoperative complications, increasing the chances of success and cure of the patient.(AU)

Subcutaneous advancement flap for snout reconstruction after traumatic injury in a dog: case report / Retalho em avanço de padrão subdérmico para reconstrução de focinho após lesão traumática em canino: relato de caso

Reconstructive plastic surgery in companion animals is increasing in surgical blocks. Pedicle skin flaps on the face of dogs and cats are of difficult execution, making it challenging for the surgeon. The objective of this work is to report a skin reconstruction of a dog's face after trauma. A male dog of unknown breed, presenting trauma of unknown cause with total loss of snout and part of incisive bone, was attended at the Veterinary Hospital of the Federal University of Pará, Brazil. Emergency care was performed and the animal was referred for surgical debridement of the lesion and posterior plastic correction. A subcutaneous facial advancement flap was used to cover the wound, demonstrating that this is a good option in this region due to the low elasticity of the skin. There were no intercurrences in the postoperative period and the animal presented good functional and cosmetic results.

A cirurgia plástica reconstrutiva em animais de companhia vem cada vez mais tomando espaço dentro do bloco cirúrgico. Retalhos pediculados de pele em face de cão e gato são de difícil execução tornando-se desafiador para o cirurgião. O objetivo deste trabalho é relatar a reconstrução cutânea de face de um cão após trauma. Foi atendido no Hospital Veterinário da Universidade Federal do Pará um cão, macho, sem raça definida, apresentando trauma de causa desconhecida com perda total de focinho e parte de osso incisivo. Foi realizado o atendimento emergencial e encaminhado para desbridamento cirúrgico da lesão e posterior correção plástica. Foi realizado um retalho de padrão subdérmico de avanço facial para cobertura da ferida, demonstrando este ser uma boa opção nessa região devido à pouca elasticidade da pele. Não houve intercorrências no pós-operatório e o animal apresentou bons resultados funcionais e cosméticos.

Subcutaneous advancement flap for snout reconstruction after traumatic injury in a dog: case report / Retalho em avanço de padrão subdérmico para reconstrução de focinho após lesão traumática em canino: relato de caso

Reconstructive plastic surgery in companion animals is increasing in surgical blocks. Pedicle skin flaps on the face of dogs and cats are of difficult execution, making it challenging for the surgeon. The objective of this work is to report a skin reconstruction of a dog's face after trauma. A male dog of unknown breed, presenting trauma of unknown cause with total loss of snout and part of incisive bone, was attended at the Veterinary Hospital of the Federal University of Pará, Brazil. Emergency care was performed and the animal was referred for surgical debridement of the lesion and posterior plastic correction. A subcutaneous facial advancement flap was used to cover the wound, demonstrating that this is a good option in this region due to the low elasticity of the skin. There were no intercurrences in the postoperative period and the animal presented good functional and cosmetic results.(AU)

A cirurgia plástica reconstrutiva em animais de companhia vem cada vez mais tomando espaço dentro do bloco cirúrgico. Retalhos pediculados de pele em face de cão e gato são de difícil execução tornando-se desafiador para o cirurgião. O objetivo deste trabalho é relatar a reconstrução cutânea de face de um cão após trauma. Foi atendido no Hospital Veterinário da Universidade Federal do Pará um cão, macho, sem raça definida, apresentando trauma de causa desconhecida com perda total de focinho e parte de osso incisivo. Foi realizado o atendimento emergencial e encaminhado para desbridamento cirúrgico da lesão e posterior correção plástica. Foi realizado um retalho de padrão subdérmico de avanço facial para cobertura da ferida, demonstrando este ser uma boa opção nessa região devido à pouca elasticidade da pele. Não houve intercorrências no pós-operatório e o animal apresentou bons resultados funcionais e cosméticos.(AU)

Preputial repair as an alternative to penectomy in dogs - report of two cases / Reconstrução prepucial como alternativa à penectomia em cães - relato de dois casos

Extensive foreskin and penile lesions are the main indications of penectomy in the dog. Such a surgical approach results in high morbidity and risk of infection. A viable alternative to penectomy comprises preputial reconstruction after resection of extensive benign lesions. The aim of this study was to report the case of two dogs with extensive preputial lesions submitted to different reconstructive foreskin techniques. In both cases there were no postoperative complications, the animals did not present difficulty for penile exposure or retraction. Therefore, the techniques used in the present study are viable as alternative techniques to replace the penectomy.(AU)

Lesões extensas em prepúcio e pênis constituem as principais indicações de penectomia no cão. Tal abordagem cirúrgica resulta em elevada morbidade e risco de infecção. Uma alternativa viável à penectomia compreende a reconstrução prepucial após a ressecção de lesões extensas benignas. O objetivo deste estudo foi relatar o caso de dois cães com lesões prepuciais extensas, submetidos a diferentes técnicas reconstrutivas de prepúcio. Nos dois casos não foram verificadas complicações pós-operatórias, os animais não apresentaram dificuldade para exposição ou retração peniana. Diante disso, as técnicas utilizadas no presente estudo são viáveis como técnicas alternativas em substituição à penectomia.(AU)

Preputial repair as an alternative to penectomy in dogs - report of two cases / Reconstrução prepucial como alternativa à penectomia em cães - relato de dois casos

Extensive foreskin and penile lesions are the main indications of penectomy in the dog. Such a surgical approach results in high morbidity and risk of infection. A viable alternative to penectomy comprises preputial reconstruction after resection of extensive benign lesions. The aim of this study was to report the case of two dogs with extensive preputial lesions submitted to different reconstructive foreskin techniques. In both cases there were no postoperative complications, the animals did not present difficulty for penile exposure or retraction. Therefore, the techniques used in the present study are viable as alternative techniques to replace the penectomy.

Lesões extensas em prepúcio e pênis constituem as principais indicações de penectomia no cão. Tal abordagem cirúrgica resulta em elevada morbidade e risco de infecção. Uma alternativa viável à penectomia compreende a reconstrução prepucial após a ressecção de lesões extensas benignas. O objetivo deste estudo foi relatar o caso de dois cães com lesões prepuciais extensas, submetidos a diferentes técnicas reconstrutivas de prepúcio. Nos dois casos não foram verificadas complicações pós-operatórias, os animais não apresentaram dificuldade para exposição ou retração peniana. Diante disso, as técnicas utilizadas no presente estudo são viáveis como técnicas alternativas em substituição à penectomia.

H-plastia para retirada de melanoma e papiloma escamoso na pálpebra de um cão / H-plasty for removal of melanoma and squamous papilloma on the eyelid of a dog

Palpebral neoformations are very common in dogs, and may have different etiological origins, such as melanoma and squamous papilloma, localization generally directly affects ocular physiology, the treatment of choice is radical surgical excision, with a lower chance of recurrence, of the ideal surgical techniques is H-plasty, as this promotes a good margin of safety and reduces tension by tissue loss.(AU)

H-plastia para retirada de melanoma e papiloma escamoso na pálpebra de um cão / H-plasty for removal of melanoma and squamous papilloma on the eyelid of a dog

Palpebral neoformations are very common in dogs, and may have different etiological origins, such as melanoma and squamous papilloma, localization generally directly affects ocular physiology, the treatment of choice is radical surgical excision, with a lower chance of recurrence, of the ideal surgical techniques is H-plasty, as this promotes a good margin of safety and reduces tension by tissue loss.

Utilização de enxerto cutâneo no tratamento de ferida traumática grave associada à luxação metatarsofalangeana aberta: relato de caso / Use of cutaneous graft in the treatment of severe traumatic cutaneous wound associated with open metatarsal and falloid dislocation: case report in dogs

Na pele, quando a cicatrização por primeira intenção não é possível devido ao excesso de tensão tecidual, a melhor opção setorna a utilização de técnicas cirúrgicas reconstrutivas como retalhos e enxertos. A utilização de enxertos ou retalhos, reduzconsideravelmente o tempo de cicatrização das lesões, além de minimizar os riscos de possíveis infecções. Ademais, pela grandefrequência de lesões traumáticas múltiplas, cutâneas e ósseas que ocorrem nos pequenos animais após atropelamentos e suasinúmeras opções de tratamento, o que torna por vezes difícil a escolha da melhor conduta a estes pacientes, objetivou-se descrevero tratamento de uma ferida traumática, utilizando, açúcar, tala de Robert Jones modificada, seguido de enxerto cutâneo em malhade espessura total, em um cão que apresentava extensa ferida cutânea infectada e luxação aberta metatarsofalangeana, dandoênfase ao retorno funcional do membro. O paciente canino, foi submetido ao tratamento por segunda intenção da ferida, até amesma estar apta a receber a enxertia cutânea. Os resultados foram satisfatórios, ocorrendo cicatrização completa da ferida ereestabilização funcional do membro com 120 dias de tratamento. Conclui-se que a combinação de tratamentos, conservativoe cirúrgico, pode ser uma alternativa eficiente a amputação do membro no tratamento de ferida lacerada infectada associada aluxação articular completa(AU)

In the skin, when healing by first intention is not possible due to excess tissue tension, the best option becomes the use of reconstructive surgical techniques such as flaps and grafts. The use of grafts or flaps, greatly reduces the healing time of the lesions, in addition to minimizing the risks of possible infections. In addition, due to the great frequency of multiple traumatic, cutaneous and bone injuries that occur in small animals after running over and their innumerable treatment options, which makes it sometimes difficult to choose the best behavior for these patients, the objective was to describe the treatment of a traumatic wound, using modified Robert Jones sugar, followed by total thickness mesh cutaneous graft, in a dog that had an extensive infected cutaneous wound and open metatarsophalangeal luxation, emphasizing the functional return of the limb. The canine patient, was submitted to the second intention treatment of the wound until it was able to receive cutaneous grafting. The results were satisfactory, with complete wound healing and functional limb reestablishment with 120 days of treatment. It is concluded that the combination of conservative and surgical treatments can be an efficient alternative to limb amputation in the treatment of infected lacerated wound associated with complete joint dislocation, generating satisfactory functional and aesthetic results.(AU)