Clinical comparison of the hybrid dynamic compression plate and the castless plate for pancarpal arthrodesis in 219 dogs.

OBJECTIVE: To describe and compare a large population of dogs that had pancarpal arthrodesis (PCA) using either a hybrid dynamic compression plate (HDCP) or a CastLess Plate (CLP). STUDY DESIGN: Multicenter, retrospective, cohort study. ANIMALS: Dogs (n = 240; 261 PCA). METHODS: Medical records (2000-2012) from 12 UK orthopedic centers were reviewed for dogs that had PCA to document signalment, diagnosis, arthrodesis method, and complication rates. Follow-up data were used to compare outcome (lameness evaluation and radiographic healing) after use of HDCP and CLP plates. RESULTS: PCA was performed with HDCP in 125 cases, CLP in 105, and by other techniques in 31. Carpal hyperextension injury was the most common diagnosis in HDCP and CLP groups. Surgical site infection (18.3%) was the most common postoperative complication. There was no difference in intra- (11% HDCP, 21% CLP) or postoperative (34% HDCP, 41% CLP) complication rates. Use of external coaptation did not affect postoperative complication rates or outcome. External coaptation related complications occurred in 32% HDCP and 18% CLP (P = .02). At median follow-up, most dogs were classified as having no or mild lameness (73% HDCP, 83% CLP) and there was radiographic healing in 40% HDCP and 46% CLP (P = .8) cases. CONCLUSIONS: CLP and HDCP may both be used successfully to achieve pancarpal arthrodesis. Adjunctive external coaptation does not appear to have a measurable clinical benefit but is associated with morbidity.

Use of vacuum-assisted closure to maintain viability of a skin flap in a dog.

CASE DESCRIPTION: A 4-year-old sexually intact male Labrador Retriever-Poodle mix was admitted to the hospital for treatment of a wound in the left thoracic region. The wound had been debrided and primary closure had been performed by the referring veterinarian 4 days previously. CLINICAL FINDINGS: The dog had a 20-cm-long wound covered by a large flap of skin that extended caudally from the scapula over the left side of the thorax. A 3-cm defect was evident at the cranioventral aspect of the wound, from which purulent material was being discharged. The skin flap was necrotic, and the skin surrounding the flap was bruised. Signs of pain were elicited when the wound and surrounding region were palpated. Other findings, including those of thoracic radiography, were unremarkable. TREATMENT AND OUTCOME: The wound was debrided, and vacuum-assisted closure (VAC) was initiated for 3 days until a healthy bed of granulation tissue developed. A reconstructive procedure was performed with a rotation flap 3 days after VAC dressing removal. The VAC process was reinitiated 2 days following reconstruction because of an apparent failing of the skin flap viability. After 5 days of VAC, the flap had markedly improved in color and consistency and VAC was discontinued. Successful healing of the flap occurred without the need for debridement or additional intervention. CLINICAL RELEVANCE: Use of VAC led to a good overall outcome for the dog, with complete healing achieved. Additional evaluation of this technique for salvaging failing skin flaps is warranted in dogs, particularly considering that no reliable method for flap salvage in veterinary species has been reported to date.