Dermoid cysts formation is a complication of wound pinch grafting in a horse: A case report.

OBJECTIVES: To describe dermoid cyst formation as an uncommon complication of the pinch grafting technique in horses. STUDY DESIGN: Case report. ANIMAL: A 8 year old Arabian gelding. METHODS: Clinical presentation, imaging, treatment, and histopathology records were reviewed. The horse originally presented due to delayed healing of a laceration to the distal aspect of the metatarsus. The wound was treated initially with debridement and it was allowed to fill with healthy granulation tissue prior to pinch grafting. Two months after grafting, the horse started to show self-mutilation behavior targeting the wound site. Ultrasonographic examination revealed the presence of cystic lesions in the subcutaneous tissue in the wound bed and adjacent to the long digital extensor tendon. RESULTS: Treatment involved surgical excision of the cysts, which resulted in a resolution of the self-mutilation episodes. The specimens were submitted for histopathological investigation, which revealed findings compatible with dermoid cyst formation, suspected to be secondary to the skin-grafting procedure. CONCLUSION: Dermoid cysts formation should be considered as a potential differential diagnosis for skin graft complications in horses.

Complications and influence of cutaneous closure technique on subdermal plexus flaps in 97 dogs (2006-2022).

OBJECTIVE: To determine the incidence and severity of complications for subdermal plexus flaps in dogs and compare the complications when using sutures or staples for cutaneous closure of subdermal plexus flaps. STUDY DESIGN: Retrospective monocentric study. SAMPLE POPULATION: Ninety-seven client-owned dogs. METHODS: Dogs that underwent wound reconstruction using subdermal plexus flaps were retrospectively identified. Type of flap, cutaneous closure technique, complications and level of complication associated with their use were recorded. Follow-up was considered adequate if it was more than 10 days postoperatively or until a complication occurred. RESULTS: Complications were seen in 52 dogs (53.6%), of which 13/18 (72.2%) of dogs had cutaneous closure with skin staples versus 39/79 (49.3%) with skin sutures. The location of the mass/wound on the head and use of an advancement flap was associated with lower incidence of complications (p < .001; p = .018 respectively). Location of the mass/wound on the proximal pelvic limb was associated with a low level of complications (p = .01) on univariable analysis only. On multivariable analysis, only an increased bodyweight was associated with an increased incidence of complications (p = .029). CONCLUSIONS: Increased weight may be associated with an increased risk of complications with subdermal plexus flaps. No risk factor was found to be associated with the severity of complications. CLINICAL SIGNIFICANCE: Overall incidence of complications for subdermal plexus flaps in dogs in this study was 53.6%. The number of dogs included in the study was not sufficient to assess if the skin closure technique affects the incidence of complications.

Subjective and objective observation of Tilapia skin as auto skin graft dressing in cats.

Background: The recovery of auto skin graft is a dynamic and complex process that requires a suitable environment for vascularization as nutrition delivery to cells and donor skin reception. Aims: This research aimed to determine the effect of Tilapia skin dressing on the recovery of auto skin graft treatment on domestic cats through subjective and objective observation. Methods: Six male Indonesian local cats aged 1-2 years old weighing 3-4 kg were separated into two groups. The surgical procedure was performed in a sterile and aseptic environment. The first surgery created wound defects on the forelimb area 2 × 2 cm in size to whole groups. The wounds were left for 4 days and then treated with the following treatments; Group I (G-I) was treated with Tilapia skin dressing, and Group II (G-II) was treated with moist dressing Sofra-tulle®. The dressing of the two groups was replaced every 3 days and evaluated subjectively and objectively. Results: Subjective observation showed that skin was reddish (day 3), the bleeding test showed bleeding immediately occurred after incision, and pain response was observed on day 6 post-surgery on both treatment groups showed significantly differences with 95% confidence level (p < 0.05). Objective observation in the form of NaCl 0.9% absorption and medicine effect on auto skin graft did not show a significant difference between the two treatment groups (p > 0.05). Conclusion: Auto skin graft treatment by moist dressing showed better healing, but Tilapia skin dressing can be an alternative choice during auto skin graft treatment.

Acellular fish skin may be used to facilitate wound healing following wide surgical tumor excision in dogs: a prospective case series.

OBJECTIVE: To prospectively evaluate clinical outcomes using acellular fish skin grafts (FSGs) for the management of complete wound healing by secondary intention after wide surgical excision of skin tumors in dogs. ANIMALS: 5 dogs undergoing wide surgical excision of skin tumors on the distal extremity. CLINICAL PRESENTATION AND PROCEDURES: FSGs were applied to surgical wound beds following wide excision of the tumor. Bandages were changed weekly and additional grafts placed when integration of the previous graft was complete. The wounds were assessed for the following: dimensions, tissue health (color), time to complete epithelialization, complications, and tumor recurrence. RESULTS: All masses were excised with 2-cm lateral margins and 1 fascial plane deep to the tumor. Tumor diagnoses included 3 mast cell tumors and 2 soft tissue sarcomas. Surgical wounds had a median area of 27.6 cm2 (range, 17.6 to 58.7 cm2). The median number of FSG applications was 5 (range, 4 to 9 applications). Complete epithelialization occurred within 7 to 9 weeks for uncomplicated wounds (3 of 5) and 12 to 15 weeks for complicated wounds (2 of 5) that sustained self-trauma. There were no adverse events related to the use of FSGs. Local recurrence was not seen over a follow-up period ranging from 239 to 856 days. CLINICAL RELEVANCE: Wide surgical excision of distal extremity skin tumors, followed by repeated application of acellular FSGs, resulted in complete healing of all wounds with no adverse events. This treatment method does not require advanced reconstructive surgical skills and may be useful for the management of skin tumors on the distal extremities.

Use of a semitendinosus myocutaneous flap for the coverage of hindlimb full-thickness skin defects in cats.

BACKGROUND: The management of feline hindlimb full-thickness skin defects is challenging. On the other hand, the use of a semitendinosus (ST) myocutaneous flap for their coverage has not been reported. OBJECTIVES: To describe the ST flap and compare it with second intention healing for managing hindlimb full-thickness skin defects. METHODS: In 12 purpose-bred laboratory domestic short-haired cats, two wounds were made on each tibia. The wounds in group A (n = 12) were covered with ST flaps, and those in group B (n = 12) were left to heal by second intention. In both groups, clinical assessment scoring and planimetry were performed between one-30 d postoperatively. Computed tomography-angiography (CTA) was performed on days zero, 10, and 30, and histological examinations were performed on days zero and 14 and at 6 and 12 mon postoperatively. RESULTS: Statistically significant differences in the clinical assessment scores were observed between groups A and B on days 14 (p = 0.046) and 21 (p = 0.016). On the other hand, the time for complete healing was similar in the two groups. CTA revealed significant differences in the muscle width (day 0 compared to days 10 and 30 [p = 0.001, p = 0.026, respectively], and days 10 to 30 [p = 0.022]), ST muscle density, and the caliber of the distal caudal femoral artery and vein (day 0 compared to day 10 [p < 0.001], and days 10 to 30 [p < 0.001]). Histologically significant differences in inflammation, degeneration, edema, neovascularization, and fibrosis were observed on day 14 compared to zero and 6 mon, but no differences were found between the time interval of 6 and 12 mon. CONCLUSIONS: An ST flap can be used effectively to manage hindlimb full-thickness skin defects.

Enxerto em ilha para tratamento de lesão dermonecrótica em um cão atribuída a aracnidismo por Loxosceles / Island graft for the treatment of a dermonecrotic lesion in a dog attributed to loxosceles arachnidism

A picada da aranha do gênero Loxosceles, popularmente conhecidas como "aranha marrom", pode levar a uma extensa lesão dermonecrótica de difícil cicatrização e fechamento, sendo um desafio o seu tratamento. Os enxertos cutâneos são segmentos livres e independentes de pele e epiderme transferidos para um local receptor distante, normalmente utilizados para perda tecidual extensa de membros e grandes falhas dermatológicas no tronco. No presente trabalho relata-se o caso de um canino, sem raça definida, macho, 4 anos de idade, com 13,3 kg, apresentando uma lesão extensa de pele com evolução para necrose dérmica e perda substancial de tecido cutâneo, sendo associada a picada por Loxosceles spp, com base em dados da anamnese, sinais clínicos e evolução da lesão, além de ser descartado outras causas de dermonecrose como aplicação de medicamentos no subcutâneo, lesão térmica ou química. O diagnóstico de loxoscelismo raramente é baseado na identificação da aranha, tendo em vista que os tutores normalmente não observam o momento do acidente uma vez que a picada é indolor. Foi utilizado técnica de cirurgia reconstrutiva por meio de enxertos em ilha devido à extensa lesão tecidual sem possibilidade de fechamento primário com justaposição de bordas. A evolução clínica foi positiva e o animal apresentou recuperação completa após 66 dias de tratamento, sendo necessários dois procedimentos cirúrgicos de desbridamento de tecido necrótico e aproximação de bordas, associado a curativos frequentes utilizando membrana de alginato e hidrocoloide em momentos diferentes das fases de cicatrização, a fim de estimular a granulação do tecido e evitar a infecção do local. Esses cuidados foram tomados para assegurar que a região estivesse apta a receber a enxertia de pele como procedimento cirúrgico final e que a cicatrização ocorresse de forma mais rápida do que por segunda intenção, reconhecidamente lenta quando ocorre de forma espontânea, levando o paciente a maior tempo de desconforto, com alto risco de tração tecidual e contaminação local. No presente relato a cirurgia reconstrutiva se mostrou uma boa alternativa no tratamento de ferida extensa e com isso espera-se contribuir para a divulgação do uso das diversas técnicas reconstrutivas visando acelerar o processo de cicatrização e possibilitar um bom resultado final para os pacientes.

The bite of the spider of the genus Loxosceles, popularly known as the "brown spider", can lead to an extensive dermonecrotic lesion that is difficult to heal and close, making its treatment a challenge. Skin grafts are free, independent segments of skin and epidermis transferred to a distant recipient site, typically used for extensive tissue loss from limbs and large dermatological defects on the trunk. This paper reports the case of a canine, mixed breed, male, 4 years old, weighing 13.3 kg, presenting with an extensive skin lesion that progressed to dermal necrosis and substantial loss of skin tissue, associated with bite by Loxosceles spp, based on data from the anamnesis, clinical signs and evolution of the lesion, in addition to ruling out other causes of dermonecrosis such as application of subcutaneous drugs, thermal or chemical injury. The diagnosis of loxoscelism is rarely based on the identification of the spider, considering that owners usually do not observe the moment of the accident, since the bite is painless. A reconstructive surgery technique was used using island grafts due to extensive tissue damage without the possibility of primary closure with juxtaposition of edges. The clinical evolution was positive and the animal presented complete recovery after 66 days of treatment, requiring two surgical procedures for debridement of necrotic tissue and approximation of edges, associated with frequent dressings using alginate membrane and hydrocolloid at different times of the healing phases, in order to stimulate tissue granulation and avoid local infection to be able to receive skin grafting as a final surgical procedure, favoring faster healing of the lesion, since healing by second intention takes longer to occur than spontaneously, leading the patient to greater discomfort with a high risk of tissue traction and local contamination when care is not performed properly. In this case, reconstructive surgery proved to be a good alternative in the treatment of extensive wounds.

Use of skin flaps for reconstructive surgery in guinea pigs (Cavia porcellus).

BACKGROUND: The aim of the study was to investigate the use of single-pedicle advancement flaps in the fixed skin regions of the head, neck and paravertebral region in guinea pigs. METHODS: Ultrasonography was performed on the guinea pigs to visualise the vascular anatomy of the looser regions of the thorax and abdomen and the more fixed paravertebral region and neck. Flap surgeries were then planned and undertaken on seven guinea pigs, with six having tumours on the lip, under the eye, the forehead, the neck or the paravertebral pelvic region, and one having a large paravertebral pelvic scar of unknown origin altering the animal's movement. The previously recommended 2:1 flap length:base width ratio was not enough in most cases, so larger flaps (3.5:1) were required. RESULTS: All seven single-pedicle advancement flaps survived and healed with outstanding results. CONCLUSION: The authors recommend to use reconstructive surgery in guinea pigs when there is a need to close large or difficult wounds, even on areas of fixed skin. Adequate arterial supply and sufficient venous outflow can be provided with larger flap length:base width ratios than previously suggested and can lead to full recovery.

Sterile pyogranuloma syndrome in a dog successfully treated with immunosuppressive therapy and reconstructive seed grafting.

This report describes a case of sterile pyogranuloma syndrome managed with immunomodulatory therapy and seed skin grafting. Seed skin grafting can be considered as part of a multimodal treatment approach for cutaneous defects caused by ulcerative immune-mediated diseases where secondary intention healing is delayed or contraindicated, and other forms of wound reconstruction may be prohibitive.

Cet article décrit un cas de syndrome pyogranulome stérile géré avec un traitement immunomodulateur et une greffe de peau. La greffe de peau peut être considérée comme faisant partie d'une approche de traitement multimodal des défauts cutanés causés par des maladies ulcératives à médiation immunitaire où la cicatrisation secondaire est retardée ou contre-indiquée, et pour lesquelles d'autres formes de reconstruction de plaies peuvent être prohibitives.

Este artículo describe un caso de síndrome de piogranuloma estéril manejado con terapia inmunomoduladora e injerto de piel por ensemillado. El injerto de piel por ensemillado se puede considerar como parte de un enfoque de tratamiento multimodal para los defectos cutáneos causados por enfermedades ulcerativas inmunomediadas en las que la cicatrización por segunda intención se retrasa o está contraindicada, y otras formas de reconstrucción de heridas pueden ser prohibitivas.

Este relato descreve um caso de síndrome do piogranuloma estéril tratado com terapia imunomoduladora e enxerto de pele. Enxertia de pele pode ser considerada parte da terapia multimodal para defeitos cutâneos causados por doenças imunomediadas ulcerativas em que a cicatrização por segunda intenção é postergada ou contraindicada, e outras formas de reconstrução de feridas são proibitivas.

Nigeria bee honey-enhanced adherence, neovascularisation and epithelisation of full-thickness skin autografts on distal extremities of dogs.

BACKGROUND: Full thickness skin grafts (FTSGs), although ideal for resurfacing large defects of the distal extremities in veterinary patients, have a high failure rate due to issues of adherence, infection and inadequate revascularisation because of its thickness and high nutritional demand. This study investigated the effect of Nigeria bee honey on FTSG take at the distal extremities of dogs. The study was conducted on 6 adult male Nigerian indigenous dogs using 3 of the 4 limbs of each dog randomly divided into 3 treatment groups: Nigerian bee honey (HON group), platelet-rich plasma (PRP group) and normal saline (CON group). Full-thickness skin wounds (3 cm × 1.5 cm) were created on the lateral aspect of the radioulnar or metatarsal areas and dressed till adequate granulation tissues formed. Donor skins harvested from the lateral thorax of each dog were sutured to the recipient bed following application of the assigned treatment, and evaluated grossly and histologically on days 0, 4, 7, 10, 14, 17, and 21. RESULTS: A higher percentage (4/6 representing 66.7%) of complete graft take was observed in the HON and PRP groups as compared to 3/6 (50%) in the CON group. The HON group had a greater percentage (5/6 representing 83.3%) of adhered grafts as compared to the PRP (4/6 representing 66.7%) and CON (3/6 representing 50%) groups at day 4. There was a significant decrease (p = 0.022) in percentage necrosis between the CON and HON/PRP groups on day 10, 14 and 17. The percentage open mesh area for the HON group was significantly lesser at day 4, 7 and 10 when compared with CON (p < 0.001) and at day 4 when compared with PRP (p = 0.001). At histology, graft neovascularisation score was highest in the HON group on days 4, 14 and 21. CONCLUSION: Nigeria bee honey enhanced take of meshed full-thickness skin autografts by promoting adherence to the recipient bed, enhancing fibroblast proliferation and collagen laydown, and accelerating the rate of neovascularisation suggesting promising application as an alternative modality to enhance FTSG take.

Updates in Wound Management and Dressings.

Wound healing is a complex process that traverses 4 main phases which overlap and are interdependent. Many patient-related factors can impede healing by disrupting the normal pathways from one phase to the next. Wound-related factors also determine the best techniques or dressings for each patient. Species differences between cats and dogs must be understood for the successful treatment of cats. New techniques such as fish skin graft application, photobiomodulation, and bioelectric dressings hold promise as an addition to our armamentarium against wounds. NPWT, hyperbaric oxygen, regenerative medicine techniques, and low-level laser therapies yield mixed results and large-scale controlled studies are needed.

Outcome of superficial brachial axial pattern flaps used to close skin defects in dogs: 16 cases (1996-2019).

OBJECTIVES: To report the complication rate, type of complications and outcome of the superficial brachial axial pattern flap when used for closure of skin defects in dogs. MATERIALS AND METHODS: Medical records of dogs treated with a superficial brachial axial pattern flap for closure of a skin defect were reviewed. Information regarding signalment, reason for axial pattern flap use, skin flap size, flap healing, postoperative complications and need for revision surgery was collected. RESULTS: Sixteen dogs were included in the study. Indications for the superficial brachial axial pattern flap included closure following tumour removal (15/16, 94%) and management of a non-healing wound on the olecranon (1/16, 6%). Postoperative complications occurred in all dogs and included partial dehiscence (7/16, 44%), partial flap necrosis (6/16. 38%), seroma formation (5/16, 31%), flap oedema (3/16, 19%) and complete flap necrosis (2/16, 13%). Eight flaps (50%) healed without open wound management or additional surgery. Five dogs required open wound management without additional surgery, and three dogs (19%) required revision surgery. CLINICAL SIGNIFICANCE: Use of the superficial brachial axial pattern flap was associated with a high rate of complications. Most complications were managed without additional surgery and all wounds eventually healed, in some cases after prolonged open wound management.

Management of severe burn injuries with novel treatment techniques including maggot debridement and applications of acellular fish skin grafts and autologous skin cell suspension in a dog.

CASE DESCRIPTION: A 3-year-old 27-kg female spayed American Bulldog with severe burn injuries caused by a gasoline can explosion was evaluated. CLINICAL FINDINGS: The dog had extensive partial- and full-thickness burns with 50% of total body surface area affected. The burns involved the dorsum extending from the tail to approximately the 10th thoracic vertebra, left pelvic limb (involving 360° burns from the hip region to the tarsus), inguinal area bilaterally, right medial aspect of the thigh, and entire perineal region. Additional burns affected the margins of the pinnae and periocular regions, with severe corneal involvement bilaterally. TREATMENT AND OUTCOME: The dog was hospitalized in the hospital's intensive care unit for 78 days. Case management involved provision of aggressive multimodal analgesia, systemic support, and a combination of novel debridement and reconstructive techniques. Debridement was facilitated by traditional surgical techniques in combination with maggot treatment. Reconstructive surgeries involved 6 staged procedures along with the use of novel treatments including applications of widespread acellular fish (cod) skin graft and autologous skin cell suspension. CLINICAL RELEVANCE: The outcome for the dog of the present report highlighted the successful use of maggot treatment and applications of acellular cod skin and autologous skin cell suspension along with aggressive systemic management and long-term multimodal analgesia with debridement and wound reconstruction for management of severe burn injuries encompassing 50% of an animal's total body surface area.

Acellular fish skin grafts for the management of wounds in dogs and cats: 17 cases (2019-2021).

OBJECTIVE: To report the clinical outcomes of the use of acellular fish skin grafts (FSGs) for the management of complex soft tissue wounds of various etiologies in dogs and cats. ANIMALS: 13 dogs and 4 cats with complex wounds treated with FSGs between February 2019 and March 2021. PROCEDURES: Medical records were reviewed for information regarding cause, location, size of the wound, management techniques, complications, and clinical outcomes. RESULTS: In dogs, the number of FSG applications ranged from 1 to 4 (median, 2 graft applications). The time between each application ranged from 4 to 21 days (median, 9.5 days). Time to application of the first FSG ranged from 9 to 210 days (median, 19 days). Wounds closed by second-intention healing following the first fish skin application between 26 and 145 days (median, 71 days; n = 12). In cats, 1 or 2 FSGs were used, and the wounds of 3 of 4 cats healed completely by secondary intention. The wounds of 1 dog and 1 cat did not heal. There were no adverse events attributed to the use of the FSGs. CLINICAL RELEVANCE: For dogs and cats of the present study, complete healing of most wounds occurred with the use of FSGs, the application of which did not require special training, instruments, or bandage materials.

Single, large, meshed full-thickness free skin graft for reconstruction of a dorsal lumbosacral wound defect in a dog.

CASE DESCRIPTION: A 12-year-old 32-kg neutered female crossbreed dog was treated for a large lumbosacral skin defect. CLINICAL FINDINGS: The dog had sustained multiple, penetrating dog bite wounds to the lumbosacral and gluteal regions 5 days earlier. The referring veterinarian had initiated treatment with amoxicillin-clavulanic acid, which was continued at a dosage of 8.75 mg/kg, SC, every 24 hours at the referral hospital. Examination of the skin defect revealed a large subcutaneous abscess in the dorsal lumbosacral region with draining perimeter tracts at the wound margin. The partial-thickness wound measured 24 × 35 cm and had multifocal regions of necrosis extending caudally from the dorsal aspect of the T11 vertebra to the tail base. The skin defect was bounded by discolored and necrotic skin edges. TREATMENT AND OUTCOME: The dog underwent extensive soft tissue wound reconstruction. A single, large, meshed full-thickness free skin graft was harvested from the left dorsolateral aspect of the thorax and grafted to the dorsal lumbosacral region, thereby enabling successful closure of the wound defect. Primary healing of the wound eventually occurred, without postoperative complications. CLINICAL RELEVANCE: Use of a large, meshed full-thickness free skin graft led to a satisfactory outcome for this dog but required challenging postoperative management. Application of single, large, meshed full-thickness free skin grafts may be an option to manage large skin deficits in the lumbosacral area in dogs.

Use of a tilapia skin xenograft for management of a large bite wound in a dog.

A 13-year-old neutered male miniature dachshund suffered ~30% total skin loss following an attack by another dog. After numerous failed attempts at wound management and closure, the wound was successfully healed by epithelialization using tilapia skin grafts. At each tilapia skin graft placement, the wound bed appeared pink, clean, and healthy with excellent progression of epithelialization at all edges. With use of the tilapia grafts, epithelialization occurred at a rate of 1.76 mm/day. As a result, the wound reached complete closure by epithelialization with no evidence of wound contracture in 102 days. Key clinical message: Tilapia skin grafts were successfully used for management of a large bite wound in a dog and may promote accelerated epithelialization in full thickness skin wounds.

Utilisation d'une xénogreffe de peau de tilapia pour la prise en charge d'une morsure importante chez un chien. Un teckel miniature mâle castré de 13 ans a subi une perte totale de peau d'environ 30 % à la suite d'une attaque par un autre chien. Après de nombreuses tentatives infructueuses de gestion et de fermeture de la plaie, la plaie a été cicatrisée avec succès par épithélialisation à l'aide de greffes de peau de tilapia. À chaque placement de greffe de peau de tilapia, le lit de la plaie apparaissait rose, propre et sain avec une excellente progression de l'épithélialisation sur tous les bords. Avec l'utilisation des greffes de tilapia, l'épithélialisation s'est produite à un taux de 1,76 mm/jour. En conséquence, la plaie a atteint une fermeture complète par épithélialisation sans signe de contracture de la plaie en 102 jours.Message clinique clé :Les greffes de peau de tilapia ont été utilisées avec succès pour la gestion d'une grande plaie de morsure chez un chien et peuvent favoriser une épithélialisation accélérée dans les plaies cutanées de pleine épaisseur.(Traduit par Dr Serge Messier).

Filling the vacuum: Role of negative pressure wound therapy in open wound management in cats.

PRACTICAL RELEVANCE: Open wounds and their treatment present a common challenge in veterinary practice. Approaching 15 years ago negative pressure wound therapy (NPWT) started to be incorporated into clinical veterinary medicine, and its availability is becoming more widespread in Europe and the USA. Use of this therapy has the potential to significantly increase the healing rate of open wounds as well as free skin grafts in small animals, and it has been occasionally described for the management of feline wounds. AIM: This review describes the mechanisms of action of, and indications for, NPWT, and offers recommendations for NPWT specific to feline patients. EVIDENCE BASE: The information presented is based on the current evidence and the author's clinical experience of the technique gained over the past 12 years. Comparative studies of different treatment options are lacking and, since wound healing in cats and dogs differs, cat-specific studies are especially needed. Well-designed wound healing studies comparing different advanced techniques will improve open wound healing in cats in the future, and potentially allow better understanding of the role of NPWT in this setting.

Comparison of outcomes for single-session and delayed full-thickness applications of meshed skin grafts used to close skin defects after excision of tumors on the distal aspects of the limbs in dogs.

OBJECTIVE: To compare outcomes after application of full-thickness, meshed free-skin grafts in single-session versus delayed (staged) procedures after tumor excision from the distal aspects of the limbs in dogs. ANIMALS: 52 client-owned dogs. PROCEDURES: Medical records were retrospectively reviewed to identify dogs that received full-thickness, meshed free-skin grafts after tumor excision from the distal aspects of the limbs between 2013 and 2018. Signalment; diagnostic test results; comorbidities; procedure type (single session or staged); tumor characteristics; donor site, recipient site, and size of grafts; concurrent procedures; surgeon; antimicrobial administration; external coaptation type; number of bandage applications; percentage graft survival; graft outcome; postoperative complications; and time to complete healing were recorded. Graft outcome was deemed successful if there was full-thickness graft viability over ≥ 75% of the original graft area. Variables were compared between dogs grouped by procedure type. RESULTS: The number of bandage applications was significantly greater for dogs that had staged versus single-session procedures. Twenty-seven of 30 (90%) and 18 of 22 (82%) skin grafts placed in single-session and staged procedures, respectively, were successful. Percentage graft survival, graft outcome, and complication rate did not differ between groups. All complications were minor. Time to complete healing was significantly longer after staged procedures (median, 51 days) than after single-session procedures (29.5 days). CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested both procedure types are appropriate for skin graft placement. The shorter healing time and fewer bandage changes associated with single-session skin graft placement may be beneficial after tumor excision. Prospective studies are needed to confirm these findings.

Tunnel grafting for wound repair in horses: a novel technique in graft production and placement.

There are several skin grafting methods described in the human and animal literature. Currently, there are five types of free grafts used in horses: pinch and punch grafts, split and full-thickness sheet or mesh grafts and tunnel grafts. Published methods of tunnel grafting describe the use of alligator forceps. The alligator forceps create a poor tunnel and are excessively traumatic to the granulation bed. This technique utilised a 13G Jamshidi needle that was placed across the granulation bed and created a uniform tunnel. The Jamshidi needle was atraumatic to the granulation bed increasing the opportunity for graft survival. A twin bladed scalpel allowed for the quick creation of uniform width grafts. Removal of the overlying tunnel 'roof' took place 5-14 days later to allow graft expansion. This case series included five horses with distal limb wounds and one with a wither injury. Four horses required general anaesthesia for graft placement and three required general anaesthesia for the removal of the tunnel roof. The acceptance of the grafts varied from 70% to 100%. Graft expansion to cover the granulation tissue took 2-5 months. This case series demonstrates that this technique of graft production and placement is an easy method for achieving successful skin grafting. Compared to other graft types, tunnel grafts are more readily accepted. Cosmetic and functional results achieved are better than those with pinch and punch grafts. Tunnel grafting does not require expensive equipment or advanced training, and in some cases can be performed under standing sedation.

The utility of DLA typing for transplantation medicine in canine models.

Transplantation medicine is used for the treatment of severe canine diseases, and the dog leukocyte antigen (DLA) is considered to be important in graft rejection. However, the utility of direct sequencing of both DLA classes I and II has not been assessed thoroughly. Eight healthy beagles with identified DLA genes were divided into two sets of four dogs, each including one donor and three recipients for skin transplantation. The following recipients were selected: one dog with a complete match, one with a haploidentical match, and one with a complete mismatch of the DLA gene with the donor. Full-thickness skin segments were obtained from each donor and transplanted to the recipients. A mixed lymphocyte reaction (MLR) assay was performed and analyzed by flow cytometry. Skin grafts of DLA haploidentical and mismatched pairs were grossly rejected within 14 days, whereas in fully matched DLA pairs, survival was as long as 21 days. Histopathological evaluation also showed moderate to severe lymphocytic infiltration and necrosis in DLA mismatched pairs. As seen in the MLR assay, the stimulation index of DLA mismatched pairs was significantly higher than that of fully matched DLA pairs in both sets (P<0.001). The allogeneic transplantation results suggested that it is possible to prolong transplant engraftment by completely matching the DLA genotype between the donor and recipient. Additionally, the MLR assay may be used as a simplified in vitro method to select donors.

Seed skin grafts for reconstruction of distal limb defects in 15 dogs.

OBJECTIVES: To report the surgical technique of seed skin grafting and clinical application for reconstruction of wounds on the distal limb of client-owned dogs. MATERIALS AND METHODS: Medical records from The Animal Hospital at Murdoch University were retrospectively reviewed for dogs requiring reconstruction using seed grafting for distal limb skin defects between January 2009 and May 2020. RESULTS: Fifteen dogs were included. Grafting was performed on distal limb wounds at or below the carpus or tarsus, following trauma (n = 12) or neoplasia excision (n = 3). Complete epithelialisation with minimal contracture was recorded at a median of 4 weeks (range 3 to 8 weeks) after implantation. Median follow-up was 37 months (range 3 to 55 months) after grafting. Postoperative complications included epidermal inclusion cyst in two dogs. Good functional outcome with acceptable cosmesis despite sparse hair growth was achieved in all cases. CLINICAL SIGNIFICANCE: Seed grafting is a simple technique that can be used reliably to reconstruct wounds on the distal limb in dogs where other reconstructive techniques are not suitable. Complete epithelialisation with sparse hair growth, good long-term functional outcome and minimal complications can be expected.