Veterinary Medicine - January 2009 - (Page 17)

Using a scrotal mesh graft to repair degloving injuries egloving injury, secondary to trauma, is a common clinical problem in veterinary patients. Occurring most frequently on the distal limbs, these wounds can cause a high degree of morbidity because of damage and exposure of underlying tissues, including muscles, tendons, ligaments, bones, and joints. To repair large skin defects, free and pedicle grafts are used; smaller wounds are allowed to heal by second intention and re-epithelialization. This clinical report from a surgery referral practice in southern California describes the successful treatment of two intact male dogs under 2 years old with distal limb degloving injuries with full-thickness mesh skin grafts obtained by scrotal ablation castration. One dog was treated for four weeks and the other D for one week with wet-to-dry bandages to develop a healthy granulation tissue bed. Routine scrotal ablation castration was then performed, and a mesh graft was created; this tissue was applied to the injured recipient site and covered with a nonadherent dressing. New bandages were applied multiple times until day 13. One dog had 100% graft take by day 11, and the other had 90% graft take by day 9. Both dogs had acceptable function and cosmesis by days 30 and 47 after skin grafting surgery. The authors concluded that scrotal grafting was a useful option for distal limb degloving injuries. The authors state that further evaluation is needed to determine whether scrotal remnant grafting could be performed in previously neutered dogs. COMMENTARY The goal of treating distal limb degloving injuries is to reduce wound contamination or infection and to restore anatomical structures and adequate limb function. In this report, the authors have provided a novel approach to obtaining an autogenous mesh graft, which, although limited to young, healthy, intact male dogs, seems successful and technically easy to perform. Furthermore, neutering would eliminate or reduce unnecessary breeding, ﬁghting, or health issues (scrotal neoplasia, prostatitis) related to an intact status. Harris JE, Dhupa S. Treatment of degloving injuries with autogenous full thickness mesh scrotal free grafts. Vet Comp Orthop Traumatol 2008;21(4):378-381. Spinal fractures and luxations: Most common causes, most common outcomes n this review of cases treated at the University of Guelph’s Ontario Veterinary College, the medical records of 11 cats and 84 dogs treated for spinal injury between 1995 and 2005 were reviewed. Vehicular trauma was the most common (60 cases) cause of the spinal fracture or luxation. Lesions occurred most frequently between T3 and L3 (54 cases) and L4 and L7 (36 cases). Thirty patients with a median neurologic score indicating a lack of deep pain perception were euthanized without treatment. Twenty-eight ambulatory patients with a median neurologic score indicating proprioceptive deﬁcits or ataxia were treated with cage conﬁnement and exercise restriction and, in three cases, splinting; they were discharged with a median neurologic score similar to that at presentation. The median hospitalization for these animals was three days. Twenty-seven nonambulatory and 10 ambulatory patients underwent surgery that involved various techniques. The median neurologic grade of surgical patients improved by one point at discharge, and the median hospital stay was six days. A nearly fourfold increase in the complication rate was noted between surgical (27%) and nonsurgical (7%) patients. The authors concluded that patients with deep pain perception before surgery and those with voluntary motor function treated conservatively have a good prognosis for recovery. COMMENTARY I Spinal trauma is often seen in veterinary practice. Most injuries are related to vehicular trauma and can affect any portion of the vertebral column. Treatments are divided into surgical and nonsurgical categories, and, in general, most clinicians would argue for surgical decompression and stabilization for animals with unstable lesions, worsening neurologic status, and constant pain. The results of this study provide support for various treatment strategies based on clinical presentation, owner ﬁnances, and the clinician’s competency. The absence of deep pain portends a poor prognosis; however, the authors fail to describe the timing of the neurologic evaluation and any previous use of intravenous ﬂuids, corticosteroids, nonsteroidal anti-inﬂammatory medications, or analgesics. Furthermore, reporting the costs of conservative and surgical treatments would have been illuminating for veterinarians and clients. Bruce CW, Brisson BA, Gyselinck K. Spinal fracture and luxation in dogs and cats. A retrospective evaluation of 95 cases. Vet Comp Orthop Traumatol 2008;21(3):280-284. VETERINARY MEDICINE January 2009 17

Table of Contents Feed for the Digital Edition of Veterinary Medicine - January 2009

Veterinary Medicine - January 2009 Contents Leading Off Letters Research Updates Idea Exchange A Modified Subconjunctival Enucleation Technique in Dogs and Cats Local and Regional Anesthesia Techniques Author Guidelines Product Preview CE Form/Advertiser Index Marketplace/Classifieds Mind Over Miller

Veterinary Medicine - January 2009

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