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in Journal of the American Veterinary Medical Association

Abstract

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.

Open access
in Journal of the American Veterinary Medical Association
in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE

To utilize the geometry of superficial anatomic landmarks to guide incisional location and orientation for peripheral lymphadenectomy, document deep anatomic landmarks for lymphocentrum identification, and develop novel surgical approaches to the superficial cervical, axillary, and superficial inguinal lymphocentrums in dogs.

ANIMALS

12 canine cadavers.

PROCEDURES

2 cadavers were used for a pilot investigation to determine optimal body positioning, select superficial anatomic landmarks for lymphocentrum identification, and evaluate novel surgical approaches to the 3 lymphocentrums. These lymphocentrums were then dissected in 10 additional cadavers using these novel surgical approaches. Measurements of the distances from lymphocentrum to landmark and between landmarks were obtained for each lymphocentrum. Deep anatomic landmarks were recorded for each dissection. The mean and SD were calculated for each measurement and used to develop geometric guidelines for estimating the location of each lymphocentrum for these surgical approaches.

RESULTS

Each peripheral lymphocentrum was found in the same location relative to the respective, predetermined, superficial, anatomic boundaries in all cadavers. Briefly, the superficial landmarks to each lymphocentrum were as follows: (1) superficial cervical: wing of atlas, acromion process of scapula, greater tubercle of humerus; (2) axillary: caudal border of transverse head of superficial pectoral muscle, caudal triceps muscle, ventral midline; and (3) superficial inguinal: origin of pectineus muscle, ipsilateral inguinal mammary gland, ventral midline. The proposed superficial and deep surgical landmarks were identified within every cadaver. The previously undescribed surgical approaches were effective for lymphocentrum identification.

CLINICAL RELEVANCE

Anatomic landmarks provided in this study may help reduce surgical time and tissue trauma during peripheral lymphadenectomy in dogs. This study was also the first to describe a surgical approach to the superficial inguinal lymphocentrum and ventral approaches to the superficial cervical and axillary lymphocentrums and provided previously unpublished anatomic landmarks for a lateral approach to the superficial cervical lymphocentrum.

Full access
in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE

To compare the effect of a geometric, landmark-guided lymphadenectomy (LL) approach to peripheral lymph nodes (LNs) on successful LN identification, surgical time, tissue trauma, and ease of LN identification compared to standard lymphadenectomy (SL) and methylene blue–guided lymphadenectomy (MBL).

SAMPLE

18 adult, mixed-breed canine cadavers operated on by 7 veterinarians and 5 fourth-year veterinary students between July 23 and October 12, 2022.

METHODS

Participants were provided standardized, publicly available materials regarding the anatomy and surgical techniques for SL of 3 peripheral lymphocentrums: superficial cervical, axillary (ALN), and superficial inguinal (SILN). Participants performed the 3 SLs unilaterally on canine cadavers. Thereafter, they were randomly assigned to 2 crossover groups: MBL and LL. All dissections were separated by at least 2 weeks for each participant. Primary outcome measures included successful LN identification, surgical time, tissue trauma scores, and subjective difficulty.

RESULTS

Successful LN identification was highest with LL (86%) compared to SL (69%) and MBL (67%). Subjective difficulty scores were reduced with LL for SILN dissections. Tissue trauma scores were reduced when using LL for ALN and SILN compared to MBL and SL. Time to LN identification was reduced for ALN with LL. No significant differences were observed between MBL and SL, or for the superficial cervical dissections.

CLINICAL RELEVANCE

Peripheral lymphadenectomies are time consuming and difficult for veterinarians in early stages of surgical training. Little surgical guidance is provided within current literature. Geometric, landmark-guided lymphadenectomies may improve LN identification success and reduce surgical time, tissue trauma, and procedure difficulty, which could encourage their clinical application.

Full access
in Journal of the American Veterinary Medical Association