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

Poppy C. Bristow BVetMed1, Karen L. Perry BVM&S2, Zoe J. Halfacree ma, VetMB3, and Vicky J. Lipscomb ma, VetMB4
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  • 1 Queen Mother Hospital for Animals, Royal Veterinary College, University of London, North Mymms, Hatfield, Hertfordshire, AL9 7TA, England.
  • | 2 Queen Mother Hospital for Animals, Royal Veterinary College, University of London, North Mymms, Hatfield, Hertfordshire, AL9 7TA, England.
  • | 3 Queen Mother Hospital for Animals, Royal Veterinary College, University of London, North Mymms, Hatfield, Hertfordshire, AL9 7TA, England.
  • | 4 Queen Mother Hospital for Animals, Royal Veterinary College, University of London, North Mymms, Hatfield, Hertfordshire, AL9 7TA, England.

Abstract

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. (J Am Vet Med Assoc 2013;243:863–868)

Abstract

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. (J Am Vet Med Assoc 2013;243:863–868)

Contributor Notes

Address correspondence to Dr. Bristow (pbristow@rvc.ac.uk).