Case study: Dog - Soft tissue sarcoma - fore limb
01 September 2015
Seven-year-old female American Pitbull cross. Soft tissue sarcoma on left antebrachium , approx. 1.3cm in diameter. Two 25mm fast (2 week expansion) expanders used.
- Implant surgery proceeded well on 4 August 2014 (day 0)
- Separate pockets were created for the two expanders
- A dummy was used to size pockets
- Expanders inserted with fingers to avoid damage to the silicone coating
- Two layers of sutures and also stay sutures used
- Dog comfortable throughout expansion phase over 2 weeks
- Observations/checks carried out every 3-4 days
- Leg remained bandaged with padded bandaging, throughout expansion hase
- Definitive reconstruction surgery carried out on 18 August 2014 (day 14):
- Expanders extracted and tumour excised with 1cm margin
- Only just enough skin for closure (see learning points below)
- Some additional undermining and bipointed advancement flap created to achieve full closure
- Follow up carried out two weeks (day 28) after surgery: sutures removed and healing progressing very well. Both dog and owner reported as being happy.
- Learning points: in a similar case the following could be considered
- Use of expanders on either side of the surgical site – create two flaps one from either side rather than one advancing flap
- Place two expanders closer to surgical site margin and also closer to one another to avoid a ‘bridge’ of unexpanded skin between the two expanders
- Both 25mm expanders reached 95% plus of full expansion in 2 weeks, approx. 19.5mm
- No bone resorption from expansion pressure noted
- Expanded skin used for reconstruction appeared healthy and well vascularised
- Surgical site healed well after reconstruction surgery
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