Department of Clinical Studies, Ontario Veterinary College, University of Guelph, 50 Stone Road East, Guelph, Ontario N1G 2W1.
Can Vet J. 2023 Jul;64(7):620-626.
A 4-year-old, neutered male, mixed-breed dog initially presented to a tertiary referral center for suspected mushroom intoxication and subsequent necrotizing fasciitis of the right thoracic limb. One day after presentation, a fasciotomy was carried out to remove necrotic tissue, leaving an extensive cutaneous defect spanning from axilla to carpus and occupying 75 to 100% of the circumference of the limb. Following establishment of a bed of granulation tissue, a distant, direct, single-pedicle flap was performed using the lateral thoracoabdominal skin. The limb was flexed at the shoulder and secured to the body wall during flap healing. Staged division of the flap was initiated 20 d after flap harvesting and completed 3 d later. Complete reconstruction of the large circumferential cutaneous defect was obtained 56 d after initial presentation. No major complications were encountered. At 387 d postoperatively, the dog had clinically normal limb function and was free of lameness. Key clinical message: This case report demonstrates the successful use of a distant, direct, single-pedicle hinge flap for reconstruction of a large thoracic limb wound spanning from axilla to carpus in a dog. This technique should be considered a viable limb-sparing, surgical option for resolution of extensive cutaneous thoracic limb wounds.
一只 4 岁、已去势的雄性杂种犬，最初因疑似蘑菇中毒和随后右胸肢的坏死性筋膜炎而被转诊至三级转诊中心。就诊后一天，进行了筋膜切开术以切除坏死组织，留下了一个从腋窝到腕关节广泛的皮肤缺损，占据了肢体周长的 75%至 100%。在建立肉芽床后，使用侧胸腹壁皮肤进行了远侧、直接、单蒂皮瓣。在皮瓣愈合过程中，将肩部弯曲并固定在体壁上。皮瓣采集后 20 天开始分阶段切开皮瓣，3 天后完成。初次就诊后 56 天，成功完成了对大面积环形皮肤缺损的重建。未发生重大并发症。术后 387 天，狗的肢体功能临床正常，无跛行。关键临床信息：本病例报告展示了一种远侧、直接、单蒂铰链皮瓣在重建从腋窝到腕关节的大型胸肢伤口中的成功应用。该技术应被视为一种可行的保留肢体、手术选择，可解决广泛的胸肢皮肤伤口。
