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1989 - 2001年10只犬前肢皮肤缺损背阔肌轴型皮瓣重建后的并发症及结果

Complications and outcome after thoracodorsal axial pattern flap reconstruction of forelimb skin defects in 10 dogs, 1989-2001.

作者信息

Aper Rhonda, Smeak Daniel

机构信息

College of Veterinary Medicine, The Ohio State University, Columbus, OH 43210-1089, USA.

出版信息

Vet Surg. 2003 Jul-Aug;32(4):378-84. doi: 10.1053/jvet.2003.50043.

Abstract

OBJECTIVE

To determine (1) the frequency and extent of complications associated with thoracodorsal axial pattern flap reconstruction of forelimb skin defects in dogs and (2) outcome after treatment of such complications.

STUDY DESIGN

Retrospective clinical study.

SAMPLE POPULATION

Ten dogs.

METHODS

Medical records for 10 dogs that had a thoracodorsal axial pattern skin flap reconstruction of a forelimb skin defect were reviewed.

RESULTS

Three dogs had complete flap survival. Partial necrosis of the distal flap, ranging from an estimated 2% to 53% (mean, 21%) of the flap surface area, occurred in 7 dogs. Six dogs required surgical management of the skin necrosis, resulting in successful resolution in 5 dogs, whereas, in 2 dogs, the wound healed by second intention. Positive bacterial cultures were obtained from 3 dogs with distal flap necrosis. Seroma formation was noted in 2 dogs; the entire flap survived in 1 dog, whereas the second dog developed distal flap necrosis. Edema and bruising of the distal portion of the flap were noted in 8 dogs; distal flap necrosis subsequently developed in 7 dogs. Partial incisional dehiscence, which healed by second intention, occurred in 2 dogs. Of 6 owners available for follow-up, all were satisfied with the functional outcome, but 1 owner was not satisfied with the cosmetic appearance.

CONCLUSIONS

Partial flap necrosis was a frequent complication of thoracodorsal axial pattern flap reconstruction of forelimb skin defects and required additional wound care or surgical intervention to achieve healing.

CLINICAL RELEVANCE

Thoracodorsal axial pattern flaps can provide full-thickness skin coverage of extensive skin defects of the forelimb, but owners should be aware of the likelihood of local wound complications.

摘要

目的

确定(1)犬前肢皮肤缺损背阔肌轴型皮瓣重建相关并发症的发生率和严重程度,以及(2)此类并发症治疗后的结果。

研究设计

回顾性临床研究。

样本群体

10只犬。

方法

回顾10只接受前肢皮肤缺损背阔肌轴型皮瓣重建犬的病历。

结果

3只犬皮瓣完全存活。7只犬出现皮瓣远端部分坏死,坏死面积估计占皮瓣表面积的2%至53%(平均21%)。6只犬需要对皮肤坏死进行手术处理,5只犬成功治愈,而2只犬伤口通过二期愈合。3只皮瓣远端坏死的犬细菌培养呈阳性。2只犬出现血清肿;1只犬皮瓣完全存活,另一只犬出现皮瓣远端坏死。8只犬皮瓣远端出现水肿和瘀斑;随后7只犬出现皮瓣远端坏死。2只犬出现部分切口裂开,通过二期愈合。在可随访的6位主人中,所有主人对功能结果满意,但1位主人对外观不满意。

结论

部分皮瓣坏死是犬前肢皮肤缺损背阔肌轴型皮瓣重建常见的并发症,需要额外的伤口护理或手术干预才能愈合。

临床意义

背阔肌轴型皮瓣可为前肢大面积皮肤缺损提供全层皮肤覆盖,但主人应意识到局部伤口并发症的可能性。

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