Khoo T-X, Yates G, Chambers B, Ng J
Surgery Department, Centre for Animal Referral and Emergency (CARE), Collingwood, Victoria, Australia.
Surgery Department, Animal Referral Hospital, Essendon Fields, Victoria, Australia.
Aust Vet J. 2022 Dec;100(12):571-578. doi: 10.1111/avj.13204. Epub 2022 Sep 7.
To determine the incidence and characteristics of wound healing complications after folded flap palatoplasty (FFP).
Prospective study of 25 dogs that underwent FFP as a component of corrective multilevel surgery for brachycephalic obstructive airway syndrome. Oropharyngeal re-examination was conducted after a minimum of 28 days post-operatively, unless indicated earlier by the onset of clinical signs.
Wound healing complications occurred in nine dogs (36%). Minor and major wound complications were diagnosed at a median of 36 days (1.5-51 days) post-operatively. Eight dogs had major wound complications, four of which showed no associated clinical signs. Two patterns of major wound complications were observed: incisional dehiscence (ID) with caudal retraction of the soft palate mucosa and development of a full-thickness defect (FTD) in the centre of the soft palate. Revision of the soft palate surgery was performed in five dogs, failing again in one dog with ID. Clinical signs resolved in symptomatic dogs after revision surgery to close FTD.
In this study, wound healing complications were common after FFP and were not associated with significant clinical deterioration. Further research is necessary to determine the value and timing of routine post-operative oropharyngeal examination for assessment of soft palate healing after FFP as well as the indication for and success of approaches to the management of wound healing complications. The two distinct patterns of FFP failure recognised may provide insight into the underlying causes and lead to refinements in folded flap palatoplasty technique.
确定折叠瓣腭裂修复术(FFP)后伤口愈合并发症的发生率及特征。
对25只接受FFP的犬进行前瞻性研究,FFP作为短头阻塞性气道综合征矫正性多级手术的一部分。术后至少28天进行口咽复查,除非临床症状提前出现。
9只犬(36%)出现伤口愈合并发症。术后中位时间36天(1.5 - 51天)诊断出轻微和严重伤口并发症。8只犬出现严重伤口并发症,其中4只无相关临床症状。观察到两种严重伤口并发症模式:软腭黏膜尾侧回缩导致的切口裂开(ID)以及软腭中央全层缺损(FTD)的形成。5只犬进行了软腭手术修复,1只ID犬再次修复失败。修复手术关闭FTD后,有症状犬的临床症状得到缓解。
在本研究中,FFP后伤口愈合并发症常见,且与明显的临床恶化无关。有必要进一步研究确定FFP后评估软腭愈合的常规术后口咽检查的价值和时机,以及伤口愈合并发症处理方法的指征和成功率。所识别出的FFP失败的两种不同模式可能有助于深入了解潜在原因,并改进折叠瓣腭裂修复术技术。