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比较单次和延迟全厚应用网孔皮片移植在四肢远端肿瘤切除后关闭皮肤缺损的效果。

Comparison of outcomes for single-session and delayed full-thickness applications of meshed skin grafts used to close skin defects after excision of tumors on the distal aspects of the limbs in dogs.

出版信息

J Am Vet Med Assoc. 2021 Feb 15;258(4):387-394. doi: 10.2460/javma.258.4.387.

Abstract

OBJECTIVE

To compare outcomes after application of full-thickness, meshed free-skin grafts in single-session versus delayed (staged) procedures after tumor excision from the distal aspects of the limbs in dogs.

ANIMALS

52 client-owned dogs.

PROCEDURES

Medical records were retrospectively reviewed to identify dogs that received full-thickness, meshed free-skin grafts after tumor excision from the distal aspects of the limbs between 2013 and 2018. Signalment; diagnostic test results; comorbidities; procedure type (single session or staged); tumor characteristics; donor site, recipient site, and size of grafts; concurrent procedures; surgeon; antimicrobial administration; external coaptation type; number of bandage applications; percentage graft survival; graft outcome; postoperative complications; and time to complete healing were recorded. Graft outcome was deemed successful if there was full-thickness graft viability over ≥ 75% of the original graft area. Variables were compared between dogs grouped by procedure type.

RESULTS

The number of bandage applications was significantly greater for dogs that had staged versus single-session procedures. Twenty-seven of 30 (90%) and 18 of 22 (82%) skin grafts placed in single-session and staged procedures, respectively, were successful. Percentage graft survival, graft outcome, and complication rate did not differ between groups. All complications were minor. Time to complete healing was significantly longer after staged procedures (median, 51 days) than after single-session procedures (29.5 days).

CONCLUSIONS AND CLINICAL RELEVANCE

Results suggested both procedure types are appropriate for skin graft placement. The shorter healing time and fewer bandage changes associated with single-session skin graft placement may be beneficial after tumor excision. Prospective studies are needed to confirm these findings.

摘要

目的

比较在犬四肢远端切除肿瘤后,行单次手术与延迟(分期)手术应用全厚、网孔游离皮片移植的效果。

动物

52 只患犬。

方法

回顾性分析 2013 年至 2018 年期间因四肢远端肿瘤切除而接受全厚、网孔游离皮片移植的患犬的病历。记录犬的一般情况、诊断性检查结果、合并症、手术类型(单次手术或分期手术)、肿瘤特征、供皮区和受皮区及移植皮片大小、同期手术、手术医师、抗菌药物的应用、外固定方式、绷带更换次数、移植皮片成活率、移植皮片效果、术后并发症和完全愈合时间。若移植皮片的原始面积≥75%有全厚皮片存活,则认为移植皮片效果成功。比较按手术类型分组的犬之间的变量。

结果

分期手术的犬绷带更换次数明显多于单次手术的犬。单次手术和分期手术中分别有 30 个(90%)和 22 个(82%)皮片移植成功。两组间移植皮片成活率、移植皮片效果和并发症发生率差异均无统计学意义。所有并发症均为轻度。分期手术的完全愈合时间(中位数,51 天)显著长于单次手术(29.5 天)。

结论和临床相关性

结果提示两种手术类型均适合皮片移植。单次手术皮片移植的愈合时间较短,更换绷带的次数较少,可能有益于肿瘤切除术后的患犬。需要开展前瞻性研究来证实这些发现。

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