Reconstructive cutaneous surgery techniques in small animals
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Date
2023-02-11
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CSK HPKV, Palampur
Abstract
The present work involved standardization and clinical application of various types
of reconstruction techniques applicable to small animals. The standardization phase of the
study involved cadaveric studies carried out in 10 canine cadavers to standardize a total of
16 different reconstruction techniques coming under 3 different categories. The tension
lines on the skin at various anatomical locations and their effect on the effective closure of
cutaneous defects with the best clinical, functional and cosmetic outcomes were studied.
In the clinical application phase of the study, 31 canine patients were surgically treated
with the standardized techniques and the wound healing parameters were evaluated to
find the technique and combination of surgical parameters required to obtain the best
possible outcome out of cutaneous reconstruction. The linear reconstruction technique
was found to be an easy and good technique for small defects and when wounds can be
closed without the formation of dog ears. The fusiform technique of reconstruction was
found to be best suited for the closure of circular defects with an adequate amount of free
skin and with minimum dog-ear formation. The Combined V technique resulted in the least
healthy skin loss and should preferably be applied when skin edge apposition causes dog ear formation and when there is little skin available for restoration around the defect. The
transposition flap gave better clinical outcomes and faster healing on extremities
compared to the bipedicle flap. The delay in wound healing and occurrence of profuse
swelling was found to be more related to the tension at the time of closure than other
parameters and was mainly observed when tension was severe. Reduction of pain in all 3
techniques (CST, Electrosurgery & Laser surgery) was good with no significant difference
between each. The degree of swelling on 3rd day following surgery, degree of exudation
and oedema on the 3rd day, and completeness of healing on the 14th day after surgery had
only mild, non-significant differences between the three groups suggesting that all three
techniques for the creation of skin incision are good alternatives of each other