Application of a distant, direct, single-pedicle hinge flap for reconstruction of a circumferential cutaneous defect of the thoracic limb in a dog.

A 4-year-old, neutered male, mixed-breed dog initially presented to a tertiary referral center for suspected mushroom intoxication and subsequent necrotizing fasciitis of the right thoracic limb. One day after presentation, a fasciotomy was carried out to remove necrotic tissue, leaving an extensive cutaneous defect spanning from axilla to carpus and occupying 75 to 100% of the circumference of the limb. Following establishment of a bed of granulation tissue, a distant, direct, single-pedicle flap was performed using the lateral thoracoabdominal skin. The limb was flexed at the shoulder and secured to the body wall during flap healing. Staged division of the flap was initiated 20 d after flap harvesting and completed 3 d later. Complete reconstruction of the large circumferential cutaneous defect was obtained 56 d after initial presentation. No major complications were encountered. At 387 d postoperatively, the dog had clinically normal limb function and was free of lameness. Key clinical message: This case report demonstrates the successful use of a distant, direct, single-pedicle hinge flap for reconstruction of a large thoracic limb wound spanning from axilla to carpus in a dog. This technique should be considered a viable limb-sparing, surgical option for resolution of extensive cutaneous thoracic limb wounds.

Application d'un lambeau distant, direct, à pédicule unique pour la reconstruction d'un défaut cutané circonférentiel du membre thoracique chez un chien. Un chien de race mixte mâle castré de 4 ans a été initialement présenté à un centre de référence tertiaire pour suspicion d'intoxication aux champignons et de fasciite nécrosante subséquente du membre thoracique droit. Un jour après la présentation, une fasciotomie a été réalisée pour enlever le tissu nécrotique, laissant un vaste défaut cutané s'étendant de l'aisselle au carpe et occupant 75 à 100 % de la circonférence du membre. Après la mise en place d'un lit de tissu de granulation, un lambeau distant, direct, à pédicule unique a été réalisé en utilisant la peau thoraco-abdominale latérale. Le membre était fléchi au niveau de l'épaule et fixé à la paroi corporelle pendant la cicatrisation du lambeau. La division par étapes du lambeau a été initiée 20 jours après la récolte des lambeaux et terminée 3 jours plus tard. La reconstruction complète du grand défaut cutané circonférentiel a été obtenue 56 jours après la présentation initiale. Aucune complication majeure n'a été rencontrée. À 387 jours après l'opération, le chien avait une fonction cliniquement normale du membre et n'avait pas de boiterie.Message clinique clé :Ce rapport de cas démontre l'utilisation réussie d'un lambeau distant, direct et à pédicule unique pour la reconstruction d'une grande plaie d'un membre thoracique s'étendant de l'aisselle au carpe chez un chien. Cette technique doit être considérée comme une option chirurgicale viable épargnant les membres pour la résolution des plaies cutanées étendues des membres thoraciques.(Traduit par Dr Serge Messier).

Bilateral, single-session, laparoscopic adrenalectomy was associated with favorable outcomes in a cohort of dogs.

OBJECTIVE: To report perioperative characteristics and outcome following bilateral, single-session, laparoscopic adrenalectomy (BSSLA) in dogs. ANIMALS: Client-owned dogs (n = 6). CLINICAL PRESENTATION AND PROCEDURES: Medical records were reviewed and perioperative data collected, including preoperative diagnostic imaging, operative details, complications, and need for conversion to open laparotomy. Bilateral, single-session, laparoscopic adrenalectomy was performed on the right or left side with a standard 3- or 4-portal transperitoneal technique. The dog was repositioned to contralateral recumbency, and laparoscopic adrenalectomy was repeated. Follow-up information was collected by telephone interviews with the owners and/or referring veterinarian. RESULTS: Median age and weight of dogs were 126 months and 14.75 kg, respectively. Contrast-enhanced CT (CECT) was performed in all dogs. Median maximal tumor diameter was 2.6 and 2.3 cm for the right and left-sided tumors, respectively. Median surgical and anesthesia times were 158 and 240 minutes, respectively. Conversion to open laparotomy was performed in 1 dog following renal vein laceration during initial adrenalectomy. Left adrenalectomy and ureteronephrectomy were performed, and the right adrenal tumor was left in situ. Cardiac arrest occurred in 1 dog following initial adrenalectomy (left); however, the dog was resuscitated successfully, and contralateral laparoscopic adrenalectomy was performed without complication. All dogs survived to hospital discharge. Follow-up ranged from 60 to 730 days (median, 264 days) for dogs that successfully underwent BSSLA. CLINICAL RELEVANCE: BSSLA was associated with favorable outcomes in this cohort of dogs. Laparoscopy may be considered in dogs with bilateral, modestly sized, noninvasive adrenal tumors.