Treatment of degloving injuries with autogenous full thickness mesh scrotal free grafts

Summary

In this report, we evaluated the effectiveness of scrotal tissue as an autogenous free skin graft to treat cutaneous degloving injuries of the distal limb in dogs. Surgery was performed on two male intact dogs with distal extremity degloving wounds. Dog #1 had a tarsal degloving wound with exposure of the distal tibial and tarsal bones. Dog #2 had a degloving injury over the metacarpals. Wounds were treated with daily wetto- dry bandages in order to develop a healthy bed of granulation tissue at the graft recipient site. Scrotal ablation castration was performed once the recipient site had been prepared. Subcutaneous and adipose tissue were excised from the scrotal graft and mesh slits were created. The graft was applied to the recipient site with monofilament absorbable simple interrupted sutures. Bandaging was performed postoperatively, and bandage changes occurred four, seven, nine and 11 days postoperatively. Follow-up was performed at 30 days. In dog #1, the tarsal degloving injury graft had first intention healing with 100% graft take on day 11. In dog #2, the metacarpal degloving injury graft had 90% graft take on day nine, with second intention healing adjacent to the fifth digit pad. The scrotum is often discarded at the time of scrotal ablation castration. Distal extremity wounds can be successfully treated with free skin grafts. In male dogs, the scrotum is a viable option as a full thickness mesh free graft for distal extremity reconstructive surgery.

Keywords

Free graft - skin graft - degloving injury - scrotum - dog

• References

• 1 Sereda CW, Lanz OI, Cross AR. et al. Concurrent use of a medial saphenous fasciocutaneous free tissue flap and external skeletal fixation for treatment of a distal antebrachial injury in a dog.. Vet Surg 2003; 32: 238-241.
• 2 Pavletic MM. Atlas of Small Animal Reconstructive Surgery.. Philadelphia: WB. Saunders; 1999: 276-295.
• 3 Acland HM. Reproductive system: male. In: McGavin MD, Carlton WW, Zachary JF, eds. Thompson’s Special Veterinary Pathology.. 3rd ed. St. Louis: Mosby; 2001: 635-652.
• 4 Boothe HW. Penis, prepuce, and scrotum.. In Slatter D, ed. Textbook of Small Animal Surgery. 3rd ed. Philadelphia: Saunders; 2003: 1531-1542.
• 5 Evans HE, Christensen CG. The urogenital system.. In: Evans HE, ed. Miller’s Anatomy of the Dog. 3rd ed. Philadelphia: WB. Saunders; 1993: 494-558.
• 6 Matera JM, Tatarunas AC, Tabacchi D. et al. Use of the scrotum as a transposition flap for the closure of surgical wounds in three dogs.. Vet Surg 2004; 33: 99-101.
• 7 Gibbs A, Tobias KM. Skin reconstruction techniques: Full-thickness mesh grafts.. Vet Med 2004; 882-890.
• 8 Hedlund CS. Surgery of the Integumentary System.. In: Fossum TW, ed. Small Animal Surgery. 2nd ed. St. Louis: Mosby; 2002: 134-228.
• 9 Swaim SF. Skin Grafts. In Slatter D, ed. Textbook of Small Animal Surgery.. 3rd ed. Philadelphia: Saunders; 2003: 321-338.
• 10 Fowler D. Distal limb and paw injuries.. Vet Clin Small Anim 2006; 36: 819-845.
• 11 Rakestraw PC, Taylor TS, Schumacher J. How to harvest, store, apply, and manage split thickness meshed grafts in horses.. AAEP Proceedings 2001; 47: 433-436.