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Skin Grafts

WARNING: Graphic Surgery Images Follow!

By Dr. Samuel Yoder

Case #1

This is a 10 month-old spayed female German Shepherd. This little girl presented to the clinic due to a fast-growing lump on her left elbow. The lump was found to be calcinosis circumscripta, which is a disease commonly found in German Shepherds. If not removed, this growth would continue to grow and become very inflamed. 

The problem with a lump this size is that there is not enough skin on the elbow to allow skin coverage of the removed lump; it requires a specialized skin graft. Below is a representation of a lateral thoracic axial pattern flap. Dr. Yoder performed this procedure to take extra skin from the chest wall, and rotate it to cover up the elbow skin deficit.

The image below was taken 2 weeks post-surgery. It's looking good and healing well. 

This is her leg 1 month post surgery. She healed, and went on to a full recovery!

Case #2

This gorgeous girl is a 13 year-old spayed female Lab. She presented with a malignant cancerous growth right above the outside of her left ankle. This is a bad area for removal of a growth because there is no extra skin. 

To provide the skin coverage for this tumor, a genicular axial pattern flap was performed, which involves taking the skin from the outside of the thigh and rotating it down over the skin deficit created from removing the tumor above the ankle. 

Below is a representation of a genicular axial pattern flap

1 month post-surgery:

...and here she is, fully recovered. Success!

Case #3

This is a 1 year-old male, neutered German Shepherd who was seen by Dr. Yoder due to an inflamed sore: a swollen metacarpal pad, which is the large pad on the bottom of the foot. This dog also was found to have calcinosis circumscripta. This disease needs to be surgically removed because of its continuous progression and lack of skin for coverage on the foot.

The inflamed paw prior to surgery:

In this case, Dr. Yoder performed a digital pad transfer; this involves the removal of three bones in the toe, and the transfer of that toe’s pad to replace the removal of the metacarpal pad where the growth was removed.

Representation of a digital pad transfer:

This is an image of the paw right after surgery, taken from the side of the foot. The bones have been removed from the toe, and the toe’s pad has been transferred to the large metacarpal pad where the growth was removed. 

Success! This is the pad 1 month post-surgery:

Case #4

This is an 11-year old male neutered Borzoi. He presented with a large invasive sarcoma tumor on left flank. Removal of this tumor demands wide and deep margins to prevent recurrence. Unfortunately, this creates too much loss of skin to do a primary closure. Therefore a caudal superficial epigastric axial pattern flap was performed to take skin from his ventrum, or belly, to cover where the sarcoma tumor was removed.

^Wide incision around sarcoma tumor on the left flank with surgical prep and draping in place.

Isolation of tumor for removal. A deep margin would occur next.

Start isolation of caudal superficial epigastric axial pattern flap for transfer to left flank.

Transfer of flap over where the sarcoma tumor was positioned.

Post-surgery with a compression bandage.

Awake and with pain relief.

Flap at two weeks post-surgery with small dehiscence (wound rupture along a surgical incision) cranially, or in forward area.

One year later with skin regrowth and sarcoma tumor-free!

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