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.

Hipospadia peniana em cão ­ Relato de caso / Penile hypospadias in a dog - Case report / Hipospadias peneana en un perro ­ Reporte de caso

A hipospadia é oresultado de falha no desenvolvimento em que não ocorre a fusão normal das dobras genitais e intumescência genital, o que causa desenvolvimento anormal da uretra peniana, do pênis, prepúcio e/ou escroto. O objetivodeste relato é descrever um caso de hipospadia peniana de um canino macho, sem raça definida (SRD), de oito meses deidade, atendido no Hospital Veterinário da Universidade Federal Rural da Amazônia, na cidade de Belém/Pará, detalhando os procedimentos cirúrgico e anestésico utilizados para resolução do caso. Ao chegar ao hospital, o animal foi submetido ao exame físicoinicial no qual observou-se uma deformidade na região perianal por onde drenava a urina e uma abertura na região prepucial. A partir disso, foi solicitada a uretrocistografia retrógrada para complemento diagnóstico da hipospadia e seu comprometimento ao sistema urinário interno. Diante disso, foi realizado procedimento cirúrgico reconstrutivo e orquiectomia terapêutica, alcançando permitindoa resolução do caso e a recuperação completa do animal. Considerando que essa deformidade impossibilita a capacidadesexual generandi, a resolução recomendada é a cirúrgica, na qual o prognóstico é bom, possibilitando qualidade de vida ao animal.(AU)

Hypospadias is the result of developmental failure where normal fusion of the genital folds and genital tumescence does not occur, which causes abnormal development of the penile urethra, penis, foreskin and/or scrotum. The objective of this report is to describe a case of penile hypospadias in an eight-month-old male mixed breed (SRD) canine, treated at the Veterinary Hospital of the Federal Rural University of Amazônia, in the city of Belém/Pará, detailing the procedures surgical and anesthetic used for resolution of the case. Upon arrival at the hospital, the animal underwent an initial physical examination in which a deformity was observed in the perianal region through which urine drained and an opening in the preputial region. From this, a retrograde urethrocystography was requested to complement the diagnosis of hypospadias and its commitment to the internal urinary system. In view of this, a reconstructive surgical procedure and therapeutic orchiectomy were performed, allowing the resolution of the case and the complete recovery of the animal. Considering that this deformity prevents the sexual capacity generandi, the recommended resolution is surgery, in which the prognosis is good, allowing quality of life for the animal.(AU)

La hipospadias es el resultado de una falla en el desarrollo donde no ocurre la fusión normal de los pliegues genitales y la tumescencia genital, lo que provoca un desarrollo anormal de la uretra peneana, el pene, el prepucio y/o el escroto. El objetivo de este relato es describir un caso de hipospadias peneana en un canino macho mestizo (SRD) de ocho meses de edad, atendido en el Hospital Veterinario de la Universidad Federal Rural de Amazônia, en la ciudad de Belém/Pará, detallando los procedimientos quirúrgicos y anestésicos utilizados para la resolución del caso. A su llegada al hospital, el animal fue sometido a un examen físico inicial en el que se observó una deformidad en la región perianal por donde salía la orina y una abertura en la región prepucial. A partir de ello se solicitó cistouretrografía retrógrada para complementar el diagnóstico de hipospadias y su afectación en el sistema urinario interno. Ante esto, se realizó un procedimiento quirúrgico reconstructivo y orquiectomía terapéutica, que permitió la resolución del caso y la recuperación completa del animal. Teniendo en cuenta que esta deformidad imposibilita la capacidadgeneradi sexual, la resolución recomendada es la cirugía, en la que el pronóstico es bueno, permitiendo calidad de vida para el animal.(AU)

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.

Use of omentum flap for induction of free skin graft healing / [Utilização de flap de omento para indução da cicatrização de enxertos cutâneos]

The objective of this study was to assess healing induction of free skin grafts following transposition of omental flap through a subcutaneous tunnel to the recipient bed. Macroscopic and microscopic evaluations were performed. Nineteen piglets were used. Two surgical wounds were created of each subject. The graft removed from the left side (LS) was placed on the right side (RS) without the omental flap in the graft-bed (control group-CG). On the LS, an omental flap was placed between the graft removed from the RS and the recipient bed (omentum group-OG). Macroscopic evaluations showed edema, which gradually decreased on both groups. Suture dehiscence was highest at day 10 compared to other days in both groups. The CG had a higher incidence of unvitalized tissue compared to OG, although no difference was found among days of postoperative evaluation. The presence of unvitalized tissue was seen on 32% on OG and 53% on CG. Microscopic evaluations revealed higher collagenization, reepithelization, keratinization and less swelling in the OG compared to CG. In conclusion, mesh skin grafts evolved satisfactorily in swine even in newly created bedding without granulation tissue, but with appropriate vascularization. The omentum flap provided better macroscopic and microscopic outcomes regarding graft integration.

O objetivo deste estudo foi verificar a indução da cicatrização de enxertos cutâneos em malha após a utilização de flap de omento transposto através de túnel no subcutâneo até o leito receptor. Avaliações macroscópica e microscópica foram realizadas. Foram utilizados 19 suínos. Duas feridas cirúrgicas foram criadas em cada animal. O enxerto removido do lado esquerdo (LE) foi fixado do lado direito (LD), sem a presença do flap de omento entre o enxerto e o leito receptor (grupo controle - GC). No LE, foi fixado um flap de omento entre o enxerto cutâneo removido do LD e o leito receptor (grupo omento - GO). As avaliações macroscópicas mostraram que o edema diminuiu gradativamente em ambos os grupos. A deiscência foi maior no dia 10 em comparação aos demais dias, em ambos os grupos, entre os diferentes dias de avaliação. Foi verificada a presença de tecido desvitalizado em 32% do GO e em 53% no GC. Foi observada, na avaliação microscópica, maior colagenização, reepitelização, queratinização e menor edema no GO, quando comparado ao GC. Concluiu-se, com este estudo, que enxertos cutâneos em malha evoluíram satisfatoriamente em suínos, mesmo em leito receptor recém-criado e sem presença de tecido de granulação, desde que vascularizado, e que o flap de omento propiciou melhores resultados macro e microscópicos relativos à integração do enxerto.

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.

Reconstrução de palato com malha de polipropileno e prótese acrílica para correção de fístula oronasal adquirida em cão / Palate reconstruction with polypropylene mesh and acrylic prosthesis in dog for correcton of acquired oronosal fistulae

As fístulas oronosais adquiridas são defeitos que permitem a comunicação anormal entre as cavidades oral e nasal. Inúmeras causas podem ser atribuídas à etiologia de tal defeito. O presente trabalho visa relatar o caso de um cão com fístula oronasal adquirida que foi submetido à reconstrução cirúrgica do palato com o uso de malha de polipropileno e prótese acrílica. Após estabilização do quadro clínico e remoção manual das larvas, o paciente foi encaminhado para o desbridamento cirúrgico das lesões orais e correção do defeito no palato. A palatoplastia foi realizada com o uso da malha e resina de polimetilmetacrilato autopolimerizável. A malha foi suturada sobre o defeito palatino com pontos simples separados e fio náilon 3-0 nas extremidades da ferida. Em seguida, a resina foi preparada e, ao atingir consistência adequada, foi aplicada e modelada sobre o a malha de polipropileno com o auxílio de um descolador de Molt, sendo também suturada nas bordas da fístula com pontos simples separados e fio náilon 3-0. No mesmo tempo cirúrgico foi inserida uma sonda esofágica para alimentação enteral. Devido complicações cirúrgicas no pós operatório, o paciente foi submetido a mais duas intervenções cirúrgicas para desfecho satisfatório do tratamento. Conclui-se que associação entre a tela de polipropileno e a prótese acrílica foi uma alternativa exequível para a palatoplastia em cão.

Acquired oronosal fistulae are abnormal communication between the oral and nasal cavities. A oronasal fistula can be the result of different causes, like oral myiasis. The objetctive of these paper is to report the case of a dog with acquired oronasal fistula that underwent surgical reconstruction of the palate using polypropylene mesh and acrylic prosthesis. After stabilization of the patient ́s clinical condition and mecanic removal of the larvae, the dog was referred for surgical debridement of the oral lesions and correction of the defect in the palate. Palatoplasty was performed using a mesh and polymethylmethacrylate resin. The mesh was sutured over the palatal defect with separate simple suture and 3-0 naylon thread at the ends of the wound. Then, the resin was prepared and, upon reaching adequate consistency, it was applied and shaped over the polypropylene mesh with Molt peeler. It was also sutured on the edges of the fistula with separate simple suture and 3-0 nylon suture. At the same surgical time, an esophageal tube was inserted for enteral feeding. Due to complications, the dog underwent two more surgical interventions for a satisfactory treatment outcome. It is concluded that the association between the polypropylene mesh and the acrylic prosthesis was a practical alternative for palatoplasty in dogs after oral myiasis.

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.

Tubular subdermal flap to dorsal nasal reconstruction in a dolichocephalic dog: case report / Retalho tubular subdérmico para reconstrução dorsal nasal em cão dolicocefálico: relato de caso

This case report described the use of tubular subdermal flap to dorsal nasal reconstruction of an old dolichocephalic dog. A nine-year-old Dachshund female dog-weighing 10 kg presented with deep and extensive wound in the dorsal nasal region was attended at veterinary clinic, Sorocaba city, São Paulo, Brazil. The reconstructive surgical procedure was performed in three stages with an interval time of 25 days, which included the preparation of the tubular subdermal flap; the advance of the flap to the region of the tissue defect, and the removal of excess flap. The region healed 14 days after the last stage. The tubular subdermal flap was effective for treating ulcerative epithelial wounds associated with interstitial lymphoplasmocyte dermatitis and vasculitis of the dorsal nasal region of an old Dachshund dog.

O relato de caso descreveu o uso de retalho subdérmico tubular para reconstrução dorsal nasal de um cão doli-cocefálico idoso. Uma cadela da raça Dachshund, nove anos de idade, de 10 kg de massa corpórea, apresentando uma ferida extensa e profunda na região nasal dorsal, foi atendida na clínica veterinária na cidade de Sorocaba, São Paulo, Brasil. O pro-cedimento cirúrgico reconstrutivo foi realizado em três etapas com intervalo de 25 dias, que incluiu a confecção do retalho tubular subdérmico; o avanço do retalho até a região do defeito e a retirada do excesso do retalho. A região cicatrizou 14 dias após à última etapa. O retalho tubular subdérmico foi eficaz no tratamento de feridas epiteliais ulcerativas associadas com der-matite linfoplasmocitária intersticial e vasculite da região nasal dorsal de um cão da raça Dachshund idoso.

Tubular subdermal flap to dorsal nasal reconstruction in a dolichocephalic dog: case report / Retalho tubular subdérmico para reconstrução dorsal nasal em cão dolicocefálico: relato de caso

This case report described the use of tubular subdermal flap to dorsal nasal reconstruction of an old dolichocephalic dog. A nine-year-old Dachshund female dog-weighing 10 kg presented with deep and extensive wound in the dorsal nasal region was attended at veterinary clinic, Sorocaba city, São Paulo, Brazil. The reconstructive surgical procedure was performed in three stages with an interval time of 25 days, which included the preparation of the tubular subdermal flap; the advance of the flap to the region of the tissue defect, and the removal of excess flap. The region healed 14 days after the last stage. The tubular subdermal flap was effective for treating ulcerative epithelial wounds associated with interstitial lymphoplasmocyte dermatitis and vasculitis of the dorsal nasal region of an old Dachshund dog.(AU)

O relato de caso descreveu o uso de retalho subdérmico tubular para reconstrução dorsal nasal de um cão doli-cocefálico idoso. Uma cadela da raça Dachshund, nove anos de idade, de 10 kg de massa corpórea, apresentando uma ferida extensa e profunda na região nasal dorsal, foi atendida na clínica veterinária na cidade de Sorocaba, São Paulo, Brasil. O pro-cedimento cirúrgico reconstrutivo foi realizado em três etapas com intervalo de 25 dias, que incluiu a confecção do retalho tubular subdérmico; o avanço do retalho até a região do defeito e a retirada do excesso do retalho. A região cicatrizou 14 dias após à última etapa. O retalho tubular subdérmico foi eficaz no tratamento de feridas epiteliais ulcerativas associadas com der-matite linfoplasmocitária intersticial e vasculite da região nasal dorsal de um cão da raça Dachshund idoso.(AU)

Retalho de padrão axial da artéria torácica lateral para reconstrução de lesão cutânea em região de cotovelo de cão: Relato de caso / Use of lateral thoracic axial pattern flap to repair cutaneous defect in a dog elbow: Case report

Os retalhos cutâneos são técnicas de escolha para reconstrução de grandes defeitos. Objetivou-se relatar o emprego do retalho de padrão axial da artéria torácica lateral em paciente com ferida cirúrgica ocasionada imediatamente após exérese de neoformação na região da articulação do cotovelo. Foi atendido paciente canino macho, 10 anos, pesando 12 kg, apresentando neoformação em tecidos moles, de grande volume, localizada na região medial do cotovelo. Como tratamento definitivo, implementou-se a exérese marginal da neoplasma seguida de reconstrução com a técnica de retalho de padrão axial da artéria torácica lateral. A técnica possibilitou completa síntese e oclusão do defeito, obtendo-se ótima recuperação pós operatória, não sendo observada deiscência de sutura ou necrose do retalho. Conclui-se que a implementação do retalho da artéria torácica lateral foi uma técnica viável na reconstrução em cotovelo após a exérese do neoplasma no paciente relatado, observando resultados satisfatórios quanto aos aspectos funcionais e cosméticos, após o período cicatricial.

Skin flaps are suitable methods of wound closure in large cutaneous defects. I The present study aims to report the use of lateral thoracic axial pattern flap to repair an elbow wound secondary to a neoplasm resection. A 10-year-old male dog weighing 12 kg was presented with a large soft tissue neoplasm in the medial aspect of the elbow. The patient underwent surgical resection of the neoplasm using the lateral thoracic cutaneous flap to achieve a complete defect closure, resulting in an excellent postoperative wound healing without suture failure or skin flap necrosis. It is concluded that the implementation of the lateral thoracic artery flap was a viable technique in elbow reconstruction after neoplasm excision in the reported patient, with satisfactory results regarding functional and cosmetic aspects after the healing period.

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)

Cirurgia corretiva para coloboma palpebral em um felino através da técnica de transposição da comissura labial / Corrective surgery for palpebral coloboma in a feline using the technique of transposition of the lip commissure

Background: Eyelid coloboma is considered a disease caused by failure in eye development during the first semester of pregnancy. In felines, its prevalence occurs in the upper eyelids, temporal region, and bilaterally. Coloboma, whether to a large or small extent, can lead to keratoconjunctivitis sicca and trichiasis, situations that can give rise to secondary ulcerative keratitis. The only corrective method is blepharoplasty. The current work aims to report the case of corrective surgery for eyelid coloboma in a feline with a successful postoperative period, in order to corroborate the effectiveness of the technique. We also report a finding of persistent pupillary membrane. Case: A 7-month-old male feline, no defined breed, was analyzed with a purulent mucus secretion and signs of discomfort in the right eye. After the ophthalmic screening, the presence of a coloboma was identified, which occupied approximately 50% of the size of the upper eyelid, in the temporal-dorsal region of the right eye. The cat had already undergone an enucleation of the left eye due to a perforation arising from ulcerative keratitis. Together with coloboma, the presence of blepharospasm, trichiasis, keratoconjunctivitis sicca, and secondary ulcerative keratitis were diagnosed. The presence of persistent pupillary membrane was also observed, a rare condition in the feline species. To confirm the ulcer, the fluorescein test was applied and treatment with antibiotic eye drops and lacrimomimetics (tear film replacements) drops was administered until the day of surgery, one week later. Concomitant with the institution of treatment prior to surgery, blood was collected for complementary pre-surgical tests such as blood count and biochemistry, which demonstrated satisfactory results. Corrective surgery was then instituted by the technique of transposing the labial commissure...

Bovine tunica albuginea conserved in honey as xenograft for cystoplasty in rats / Túnica albugínea bovina conservada em mel como xenoenxerto na cistoplastia em ratos

ABSTRACT: Urinary bladder damages leading to few viable bladder tissue available might demand a challenging reconstructive surgery. In this context, biomaterials are valid alternatives for bladder reconstruction. This study evaluated the bovine tunica albuginea fragment as graft material for cystoplasty in rats and honey-preserved implant viability.Thirty Wistar rats were assigned to two groups: (1) a test group (T) with a circular 1.0-cm-diameterbovine tunica albuginea graft application in the apex region by a continuous absorbable (Polyglactin 910 5-0) suture with stitching of all bladder layers and (2) a simulation group (S) in which animals underwent only partial cystectomy. In addition, each of these groups was further divided into three subgroups according to euthanasia period on post-surgery day 7, 15 and 30.Two animals had self-limiting hematuria at postsurgical period. At necropsy, frequent crystals and adhesion to the peritoneum were observed. At the histopathological evaluation, animals from the T group euthanized by 15th postoperative day had layers disorganization and initial muscle development, while T group rats euthanized by 30th postoperative day showed complete urothelization. Urothelization pattern was similar in both groups. Moreover, the muscular layer formation was present in both groups, but more evident in S group animals. Nevertheless, inflammatory infiltrate and neovascularization were remarkably more intense in T group rats.It might be concluded that bovine tunica albuginea graft was successful in repairing rats' bladder, being a good biomaterial option in reconstructive urinary vesicle surgery.

RESUMO: Lesões na vesícula urinária que culminem em pouco tecido vesical viável podem demandar cirurgias reconstrutivas desafiadoras. Neste contexto, biomateriais são alternativas válidas para a reconstrução da bexiga. O objetivo deste trabalho foi avaliar a túnica albugínea bovina como material para enxerto na cistoplastia em ratos, assim como a viabilidade deste implante preservado em mel. Trinta ratos Wistar foram divididos em dois grupos: (1) um grupo teste (T), no qual os animais foram submetidos a cistectomia parcial seguida de cistoplastia com aplicação do enxerto circular com 1,0cm de diâmetro de túnica albugínea bovina na região do ápice com sutura absorvível (Poliglactina 910 5-0) em padrão contínuo englobando todas as camadas da bexiga; e (2) um grupo simulação (S), cujos ratos realizaram apenas cistectomia parcial. Além disso, cada grupo foi posteriormente dividido em três subgrupos de acordo com a data de eutanásia no dia 7, 15 ou 30 de pós-operatório.Dois animais apresentaram hematúria autolimitante no período de observação pós-operatória. Na necrópsia, notaram-se cristais frequentes e aderências entre bexiga e peritônio. Na avaliação histopatológica, animais do grupo T eutanasiados com 15 dias de pós-operatório apresentavam camadas vesicais desorganizadas e formação de musculatura inicial na bexiga, enquanto aqueles eutanasiados com 30 dias de cirurgia mostraram urotelização completa. O padrão de urotelização foi semelhante nos dois grupos. Além disso, a formação da camada muscular esteve presente em ambos os grupos, porém mais evidente nos animais do grupo S. No entanto, o infiltrado inflamatório bem como a neovascularização foram notavelmente mais intensos nos ratos do grupo T.Pode-se concluir que o enxerto de túnica albugínea bovina foi bem sucedido no reparo da vesícula urinária de ratos, demonstrando ser uma boa opção de biomaterial para cirurgias reconstrutivas da vesícula urinária.

Bovine tunica albuginea conserved in honey as xenograft for cystoplasty in rats / Túnica albugínea bovina conservada em mel como xenoenxerto na cistoplastia em ratos

Urinary bladder damages leading to few viable bladder tissue available might demand a challenging reconstructive surgery. In this context, biomaterials are valid alternatives for bladder reconstruction. This study evaluated the bovine tunica albuginea fragment as graft material for cystoplasty in rats and honey-preserved implant viability. Thirty Wistar rats were assigned to two groups: (1) a test group (T) with a circular 1.0-cm-diameterbovine tunica albuginea graft application in the apex region by a continuous absorbable (Polyglactin 910 5-0) suture with stitching of all bladder layers and (2) a simulation group (S) in which animals underwent only partial cystectomy. In addition, each of these groups was further divided into three subgroups according to euthanasia period on post-surgery day 7, 15 and 30. Two animals had self-limiting hematuria at postsurgical period. At necropsy, frequent crystals and adhesion to the peritoneum were observed. At the histopathological evaluation, animals from the T group euthanized by 15th postoperative day had layers disorganization and initial muscle development, while T group rats euthanized by 30th postoperative day showed complete urothelization. Urothelization pattern was similar in both groups. Moreover, the muscular layer formation was present in both groups, but more evident in S group animals. Nevertheless, inflammatory infiltrate and neovascularization were remarkably more intense in T group rats. It might be concluded that bovine tunica albuginea graft was successful in repairing rats bladder, being a good biomaterial option in reconstructive urinary vesicle surgery.(AU)

Lesões na vesícula urinária que culminem em pouco tecido vesical viável podem demandar cirurgias reconstrutivas desafiadoras. Neste contexto, biomateriais são alternativas válidas para a reconstrução da bexiga. O objetivo deste trabalho foi avaliar a túnica albugínea bovina como material para enxerto na cistoplastia em ratos, assim como a viabilidade deste implante preservado em mel. Trinta ratos Wistar foram divididos em dois grupos: (1) um grupo teste (T), no qual os animais foram submetidos a cistectomia parcial seguida de cistoplastia com aplicação do enxerto circular com 1,0cm de diâmetro de túnica albugínea bovina na região do ápice com sutura absorvível (Poliglactina 910 5-0) em padrão contínuo englobando todas as camadas da bexiga; e (2) um grupo simulação (S), cujos ratos realizaram apenas cistectomia parcial. Além disso, cada grupo foi posteriormente dividido em três subgrupos de acordo com a data de eutanásia no dia 7, 15 ou 30 de pós-operatório. Dois animais apresentaram hematúria autolimitante no período de observação pós-operatória. Na necrópsia, notaram-se cristais frequentes e aderências entre bexiga e peritônio. Na avaliação histopatológica, animais do grupo T eutanasiados com 15 dias de pós-operatório apresentavam camadas vesicais desorganizadas e formação de musculatura inicial na bexiga, enquanto aqueles eutanasiados com 30 dias de cirurgia mostraram urotelização completa. O padrão de urotelização foi semelhante nos dois grupos. Além disso, a formação da camada muscular esteve presente em ambos os grupos, porém mais evidente nos animais do grupo S. No entanto, o infiltrado inflamatório bem como a neovascularização foram notavelmente mais intensos nos ratos do grupo T. Pode-se concluir que o enxerto de túnica albugínea bovina foi bem sucedido no reparo da vesícula urinária de ratos, demonstrando ser uma boa opção de biomaterial para cirurgias reconstrutivas da vesícula urinária.(AU)

Retalho de padrão axial da artéria torácica lateral para reconstrução de lesão cutânea em região de cotovelo de cão: Relato de caso / Use of lateral thoracic axial pattern flap to repair cutaneous defect in a dog elbow: Case report

Os retalhos cutâneos são técnicas de escolha para reconstrução de grandes defeitos. Objetivou-se relatar o emprego do retalho de padrão axial da artéria torácica lateral em paciente com ferida cirúrgica ocasionada imediatamente após exérese de neoformação na região da articulação do cotovelo. Foi atendido paciente canino macho, 10 anos, pesando 12 kg, apresentando neoformação em tecidos moles, de grande volume, localizada na região medial do cotovelo. Como tratamento definitivo, implementou-se a exérese marginal da neoplasma seguida de reconstrução com a técnica de retalho de padrão axial da artéria torácica lateral. A técnica possibilitou completa síntese e oclusão do defeito, obtendo-se ótima recuperação pós operatória, não sendo observada deiscência de sutura ou necrose do retalho. Conclui-se que a implementação do retalho da artéria torácica lateral foi uma técnica viável na reconstrução em cotovelo após a exérese do neoplasma no paciente relatado, observando resultados satisfatórios quanto aos aspectos funcionais e cosméticos, após o período cicatricial.(AU)

Skin flaps are suitable methods of wound closure in large cutaneous defects. I The present study aims to report the use of lateral thoracic axial pattern flap to repair an elbow wound secondary to a neoplasm resection. A 10-year-old male dog weighing 12 kg was presented with a large soft tissue neoplasm in the medial aspect of the elbow. The patient underwent surgical resection of the neoplasm using the lateral thoracic cutaneous flap to achieve a complete defect closure, resulting in an excellent postoperative wound healing without suture failure or skin flap necrosis. It is concluded that the implementation of the lateral thoracic artery flap was a viable technique in elbow reconstruction after neoplasm excision in the reported patient, with satisfactory results regarding functional and cosmetic aspects after the healing period.(AU)

Retalho de padrão axial da artéria torácica lateral para reconstrução de lesão cutânea em região de cotovelo de cão: Relato de caso / Use of lateral thoracic axial pattern flap to repair cutaneous defect in a dog elbow: Case report

Os retalhos cutâneos são técnicas de escolha para reconstrução de grandes defeitos. Objetivou-se relatar o emprego do retalho de padrão axial da artéria torácica lateral em paciente com ferida cirúrgica ocasionada imediatamente após exérese de neoformação na região da articulação do cotovelo. Foi atendido paciente canino macho, 10 anos, pesando 12 kg, apresentando neoformação em tecidos moles, de grande volume, localizada na região medial do cotovelo. Como tratamento definitivo, implementou-se a exérese marginal da neoplasma seguida de reconstrução com a técnica de retalho de padrão axial da artéria torácica lateral. A técnica possibilitou completa síntese e oclusão do defeito, obtendo-se ótima recuperação pós operatória, não sendo observada deiscência de sutura ou necrose do retalho. Conclui-se que a implementação do retalho da artéria torácica lateral foi uma técnica viável na reconstrução em cotovelo após a exérese do neoplasma no paciente relatado, observando resultados satisfatórios quanto aos aspectos funcionais e cosméticos, após o período cicatricial.

Skin flaps are suitable methods of wound closure in large cutaneous defects. I The present study aims to report the use of lateral thoracic axial pattern flap to repair an elbow wound secondary to a neoplasm resection. A 10-year-old male dog weighing 12 kg was presented with a large soft tissue neoplasm in the medial aspect of the elbow. The patient underwent surgical resection of the neoplasm using the lateral thoracic cutaneous flap to achieve a complete defect closure, resulting in an excellent postoperative wound healing without suture failure or skin flap necrosis. It is concluded that the implementation of the lateral thoracic artery flap was a viable technique in elbow reconstruction after neoplasm excision in the reported patient, with satisfactory results regarding functional and cosmetic aspects after the healing period.

Skin graft associated with platelet-rich plasma in correcting extensive injuries resulting from the resection of skin cancer chemically induced in rats

ABSTRACT Purpose: To evaluate whether using platelet-rich plasma (PRP) in the graft recipient bed after the resection of a neoplasia can influence its recurrence because this product stimulates angiogenesis, mitogenesis and chemotaxis. Methods: A study with 30 rats Wistar (Rattus norvegicus albinus), which were separated into group A (induction of carcinogenesis, PRP in the postoperative period) and group B (induction of carcinogenesis, absence of PRP in the postoperative period), with 15 animals in each. Carcinogenesis was induced on the skin of the animals' chest by the topical application of 0.5% dimethylbenzantracene (DMBA) diluted in acetone. After surgical resection of the induced neoplasia, PRP was used to stimulate angiogenesis before surgical wound synthesis. Data on the control and experimental groups and macroscopic and microscopic variables were evaluated using analysis of variance and the Tukey's test (5%). Results: It was possible to determine that the use of PRP is good in reconstructive surgeries, but it is contraindicated in patients during tumor resection, as it can cause changes in the surgical bed, in addition to stimulating recurrences and metastases. Conclusions: PRP may interact with tumour cells that were in the recipient site of the surgical wound during the resection of a neoplasia, and a local recurrence process can be triggered by applying this product.

Enxerto cutâneo em semeadura associado à malha não aderente em membro pélvico de um cão / Island skin graft associated with non-adherent mesh in a dog's pelvic limb

Background: Large skin defects are caused by tumor excision, making appropriate reconstruction and complete healingof the lesion a challenge for surgeons. There are some difficulties in reaching these goals, especially in cases of surgicalwound in the limbs, due to the scarce amount of skin and its reduced elasticity, which limit the possibility of flaps whencompared to the head, neck, and trunk. This study reports a case of wound closure on the lateral skin in the femoral regionof a dog’s pelvic limb via island skin graft associated with the implantation of a non-adherent cellulose acetate mesh andintensive 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 beformed. Subsequently, the island skin grafting technique was chosen to close the wound, associated with the implantationof a non-adherent cellulose acetate mesh imbibed with petrolatum emulsion to keep the grafted fragments in place. Themesh 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. Thefragments were obtained using a 10-mm biopsy punch and scalpel, and the defects were sutured in a simple interruptedpattern using 2-0 nylon thread. The patient remained hospitalized for movement restriction and postoperative monitoringfor 72 h, and the bandage remained untouched during this time interval. Thereafter, the patient...

Enxerto cutâneo em semeadura associado à malha não aderente em membro pélvico de um cão / Island skin graft associated with non-adherent mesh in a dog's pelvic limb

Background: Large skin defects are caused by tumor excision, making appropriate reconstruction and complete healingof the lesion a challenge for surgeons. There are some difficulties in reaching these goals, especially in cases of surgicalwound in the limbs, due to the scarce amount of skin and its reduced elasticity, which limit the possibility of flaps whencompared to the head, neck, and trunk. This study reports a case of wound closure on the lateral skin in the femoral regionof a dogs pelvic limb via island skin graft associated with the implantation of a non-adherent cellulose acetate mesh andintensive postoperative care.Case: An 8-year-old Rottweiler female dog was attended at Pontifical Catholic University of Paranás 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 beformed. Subsequently, the island skin grafting technique was chosen to close the wound, associated with the implantationof a non-adherent cellulose acetate mesh imbibed with petrolatum emulsion to keep the grafted fragments in place. Themesh 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. Thefragments were obtained using a 10-mm biopsy punch and scalpel, and the defects were sutured in a simple interruptedpattern using 2-0 nylon thread. The patient remained hospitalized for movement restriction and postoperative monitoringfor 72 h, and the bandage remained untouched during this time interval. Thereafter, the patient...(AU)