Atlas of small animal wound management and reconstructive surgery 5th Edition by Michael Pavletic ISBN 1394209487 978-1394209484

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ISBN 10: 1394209487
ISBN 13: 978-1394209484
Author: Michael Pavletic

Fully updated new edition of the state-of-the-art, image-driven reference on surgical reconstruction and wound management in dogs and cats

Taking a visual approach to the topic with detailed line drawings and high-quality clinical photographs to demonstrate the techniques described, Atlas of Small Animal Wound Management and Reconstructive Surgery provides detailed step-by-step procedures for surgical reconstruction and key information on wound management in dogs and cats. The Atlas covers all body regions, including the face, ears, mouth, eyelids, nose, trunk, external genitalia, and feet.

The Fifth Edition has been thoroughly revised to include new techniques, updated information, and references. Over 30 new technique plates have been added and the atlas now includes over 200 colored plates and illustrations. There is a dramatic increase in photographic case series supporting the illustrations.

Written by an accomplished veterinary surgeon based on the author’s years of research and clinical experience, Atlas of Small Animal Wound Management and Reconstructive Surgery includes detailed information on:

• Anatomy of the skin, principles of wound healing and wound management, topical wound care products, management of common complications, and bandages, dressings, external splints, and protective devices
• Wound drainage techniques, negative pressure wound therapy, and management of specific wounds including bites, thermal, frostbite, gunshot/arrow wounds, pressure ulcers, hygromas, snake/spider bites, and porcupine quills
• Tension relieving techniques, skin stretching techniques, tissue expanders, local and distant skin flaps, axial pattern skin flaps, skin grafting techniques, and surgical dermatome
• Facial, nasal, eyelid, and oral reconstructive surgery, including cleft lip and cleft palate repair, muscle flaps and myocutaneous flaps, pinnal reconstruction, and aural hematoma management
• Foot pad reconstruction, reconstructive surgery of the prepuce and vulva, techniques for fecal incontinence and atresia ani, use of the omentum, and a supplemental reconstructive surgery case series

The Fifth Edition of Atlas of Small Animal Wound Management and Reconstructive Surgery is a practical, complete, and state-of-the art reference for veterinary surgeons, surgical oncologists, residents, interns, and small animal practitioners to help them effectively manage wounds and reconstruct the variety of soft tissue defects encountered in dogs and cats.

Atlas of small animal wound management and reconstructive surgery 5th Table of contents:

1 The Skin

SKIN FUNCTION

SKIN STRUCTURE

CUTANEOUS ADNEXA

THE HYPODERMIS

CUTANEOUS CIRCULATION

PINNA: CUTANEOUS CONSIDERATIONS

CONGENITAL SKIN DISORDERS

2 Basic Principles of Wound Healing

INTRODUCTION

PROCESSES OF WOUND HEALING

ACUTE VERSUS CHRONIC OPEN WOUNDS

SPECIES VARIATIONS IN WOUND HEALING

ARTIFICIAL SKIN AND SKIN SUBSTITUTES

3 Basic Principles of Wound Management

INTRODUCTION

PATIENT PRESENTATION

MECHANISMS OF INJURY AND WOUND TERMINOLOGY

WOUND CLASSIFICATION

OPTIONS FOR WOUND CLOSURE

POINTERS IN SELECTING THE PROPER CLOSURE TECHNIQUE

BASIC WOUND MANAGEMENT IN SIX SIMPLE STEPS

EXPOSED BONE: OSTEOSTIXIS

ACUTE VERSUS CHRONIC WOUNDS

4 Topical Wound‐Care Products and Their Use

WOUND EXUDATE

WOUND DRAINAGE SYSTEMS

NEGATIVE‐PRESSURE WOUND THERAPY

CONCEPT OF MOIST WOUND HEALING

TOPICAL WOUND‐CARE PRODUCTS

THE MAGGOT AND THE LEECH IN WOUND CARE

COMMON TOPICAL ANTISEPTIC AND CLEANSING AGENTS

ALTERNATIVE FORMS OF WOUND THERAPY

CONCLUDING REMARKS

Plate 1 Vacuum‐Assisted Closure

5 Dressings, Bandages, External Support, and Protective Devices

INTRODUCTION

DRESSINGS: THE PRIMARY BANDAGE LAYER

THE SECONDARY BANDAGE LAYER

THE TERTIARY BANDAGE LAYER

PREVENTING BANDAGE DISPLACEMENT

TIE‐OVER DRESSING/BANDAGE TECHNIQUE

PRESSURE POINTS: BANDAGE OPTIONS

BANDAGE “ACCESS WINDOWS”

BANDAGING TECHNIQUES FOR SKIN GRAFTS

BANDAGING TECHNIQUES FOR SKIN FLAPS

SPLINTS, CASTS, REINFORCED BANDAGES

MISCELLANEOUS PROTECTIVE DEVICES

Plate 2 Basic Bandage Application for Extremities

Plate 3 Tape Stirrups and Padding Dos and Don’ts

Plate 4 Elastikon Bandage Platforms and Saddles

Plate 5 Spica Bandages/Splints

Plate 6 Schroeder‐Thomas Splint

Plate 7 Schroeder‐Thomas Splint: Security Band Application

Plate 8 Body Brace

Plate 9 Tape Hobbles for the Rear Extremities

6 Common Complications in Wound Healing

IMPROPER NUTRITIONAL SUPPORT

MEDICATIONS AND THEIR INFLUENCE ON HEALING

HYPOVOLEMIA AND ANEMIA

THE NONHEALING WOUND: GENERAL CONSIDERATIONS

FAILURE TO HEAL BY SECOND INTENTION

SCARRING AND WOUND CONTRACTURE

INFECTION AND BIOFILM FORMATION

FOREIGN BODIES AND DRAINING TRACTS

USE OF TOURNIQUETS FOR LOWER‐EXTREMITY PROCEDURES

SEROMAS

HEMATOMAS

EXPOSED BONE

WOUND DEHISCENCE

7 Management of Specific Wounds

BITE WOUNDS

BURNS

INHALATION INJURIES

CHEMICAL BURNS

ELECTRICAL INJURIES

RADIATION INJURIES

FROSTBITE

PROJECTILE INJURIES

EXPLOSIVE MUNITIONS: BALLISTIC, BLAST, AND THERMAL INJURIES

IMPALEMENT INJURIES

PRESSURE ULCERS

HYGROMA

SNAKEBITE

BROWN RECLUSE SPIDER BITES

PORCUPINE QUILLS

LOWER‐EXTREMITY SHEARING WOUNDS

Plate 10 Pipe Insulation Protective Device: Elbow

Plate 11 Pipe Insulation to Protect the Greater Trochanter

Plate 12 Vacuum Drain Management of Elbow Hygromas

8 Regional Considerations

THE CANINE AND FELINE PROFILES

Plate 13 Surgical Technique Menu

9 Tension‐Relieving Techniques

INTRODUCTION

SKIN TENSION IN THE DOG AND CAT

Plate 14 Tension Lines

Plate 15 Effects of Skin Tension on Wound Closure

Plate 16 Patient‐Positioning Techniques

Plate 17 Undermining Skin

Plate 18 Geometric Patterns to Facilitate Wound Closure

Plate 19 V–Y‐Plasty

Plate 20 Z‐Plasty (Option I)

Plate 21 Z‐Plasty (Option II)

Plate 22 Multiple Z‐Plasties

Plate 23 Relaxing/Release Incisions

Plate 24 The “Hidden” Intradermal Release/Relaxing Incision

Plate 25 Multiple Release Incisions for Extremity Wounds

Plate 26 Suture Options to Alter Skin Traction and Retraction

Plate 27 Walking Suture Technique

Plate 28 Skin Stretchers to Offset Incisional Tension

Plate 29 “Tension” Suture Patterns

Plate 30 Retention Sutures

Plate 31 Stent

Plate 32 Skin “Directing” for Maximum Coverage

Plate 33 Relaxing Incision to Reduce Flap Tension

Plate 34 Foley Catheter Placement to Reduce Problematic Incisional Tension

10 Skin‐Stretching Techniques

PHYSIOLOGY OF SKIN STRETCHING

PRESUTURING

LOAD CYCLING

SKIN STRETCHERS

SKIN EXPANDERS

Plate 35 Presuturing Technique

Plate 36 Application of Skin Stretchers

Plate 37 Skin Stretchers to Enhance Length of Axial Pattern Flaps

Plate 38 Skin Stretcher Substitution for Presuturing

Plate 39 Skin Expanders

11 Local Flaps

INTRODUCTION

ADVANCEMENT FLAPS

ROTATING (PIVOTING) FLAPS

Plate 40 Single‐Pedicle Advancement Flap

Plate 41 Bipedicle Advancement Flap

Plate 42 Transposition Flap (90°)

Plate 43 Transposition Flap (45°)

Plate 44 Transposition Flap (Oblique Angle)

Plate 45 Local Facial Flap Options vs. Auricular Axial Pattern Flap

Plate 46 Transposition Flaps in Partial Wound Closure

Plate 47 Interpolation Flap

Plate 48 Rotation Flap

Plate 49 Forelimb Fold Flap

Plate 50 Chin Flap Options

Plate 51 Facial Fold Flap

Plate 52 Flap Closure of Dorsal Nasal Defects

12 Distant Flap Techniques

DISTANT FLAPS

DIRECT FLAPS

INDIRECT FLAPS

THE DELAY PHENOMENON

Plate 53 Direct Flap: Single‐Pedicle (Hinge) Flap

Plate 54 Direct Flap: Closure of Knee Defect

Plate 55 Direct Flap: Bipedicle (Pouch) Flap

Plate 56 Indirect Flap: Delayed Tube Flap

13 Axial Pattern Skin Flaps

INTRODUCTION: AXIAL PATTERN FLAPS

ISLAND ARTERIAL FLAPS

REVERSE SAPHENOUS CONDUIT FLAPS

SECONDARY AXIAL PATTERN FLAPS

OPTIONS TO EXTEND THE LENGTH OF AXIAL PATTERN FLAPS

POTENTIAL POSTOPERATIVE COMPLICATIONS

PLATE CONTENTS

Plate 57 Four Major Axial Pattern Flaps of the Canine Trunk

Plate 58 Skin Position and Axial Pattern Flap Development

Plate 59 Omocervical Axial Pattern Flap

Plate 60 Thoracodorsal Axial Pattern Flap

Plate 61 Lateral Thoracic Axial Pattern Flap (Dog)

Plate 62 Lateral Thoracic Axial Pattern Flap (Cat)

Plate 63 Superficial Brachial Axial Pattern Flap

Plate 64 Caudal Superficial Epigastric Axial Pattern Flap

Plate 65 Cranial Superficial Epigastric Axial Pattern Flap

Plate 66 Deep Circumflex Iliac Axial Pattern Flap: Dorsal Branch

Plate 67 Deep Circumflex Iliac Axial Pattern Flap: Ventral Branch

Plate 68 Flank Fold Flap: Hindlimb

Plate 69 Genicular Axial Pattern Flap

Plate 70 Reverse Saphenous Conduit Flap

Plate 71 Caudal Auricular Axial Pattern Flap

Plate 72 Superficial Temporal Axial Pattern Flap

Plate 73 Lateral Caudal (Tail or Coccygeal) Axial Pattern Flap

Plate 74 Cutaneous Circulation to the Feline Perineum

Plate 75 Perineal Axial Pattern Flap in Cats

14 Free Grafts

FREE SKIN GRAFTS

CLASSIFICATION OF FREE GRAFTS

GRAFT THICKNESS

PARTIAL‐COVERAGE GRAFTS

DERMATOMES

PRESERVATION BY REFRIGERATION

INTRAOPERATIVE CONSIDERATIONS

BANDAGING TECHNIQUE FOR SKIN GRAFTS

PLATE CONTENTS

Plate 76 Punch Grafts

Plate 77 Pinch Grafts

Plate 78 Strip Grafts

Plate 79 Stamp Grafts

Plate 80 Sheet Grafts

Plate 81 Dermatome: Split‐Thickness Skin Graft Harvesting

Plate 82 Mesh Grafts (with Expansion Units)

Plate 83 Mesh Grafts (with Scalpel Blades)

15 Facial Reconstruction

INTRODUCTION: FACIAL RECONSTRUCTIVE SURGERY

Plate 84 Repair of Upper Lip Avulsion

Plate 85 Repair of Lower Labial Avulsion

Plate 86 Wedge Resection Technique

Plate 87 Rectangular Resection Technique

Plate 88 Full‐Thickness Labial Advancement Technique (Upper Lip)

Plate 89 Full‐Thickness Labial Advancement Technique (Lower Lip)

Plate 90 Buccal Rotation Technique

Plate 91 Lower Labial Lift‐Up Technique

Plate 92 Upper Labial Pull‐Down Technique

Plate 93 Labial/Buccal Reconstruction with Inverse Tubed Skin Flap

Plate 94 Skin Flap for Upper Labial and Buccal Replacement (Facial [Angularis Oris] Axial Pattern Flap)

Plate 95 Feline Facial Axial Pattern Flap

Plate 96 Cleft Lip Repair (Primary Cleft, Cheiloschisis, Harelip)

Plate 97 Unilateral Rostral Labial Pivot Flaps

Plate 98 Bilateral Rostral Labial Pivot Flaps

Plate 99 Oral Commissure Advancement (Commissurorraphy) Technique

Plate 100 Brachycephalic Facial Fold Correction

Plate 101 Upper Labial Flap Reconstruction of Nasocutaneous Fistulas

Plate 102 Full‐Thickness Lower Labial Transposition Flap

Plate 103 Cheilopexy Technique for Drooling

16 Myocutaneous Flaps and Muscle Flaps

INTRODUCTION

MYOCUTANEOUS FLAPS

MUSCLE FLAPS

Plate 104 Latissimus Dorsi Myocutaneous Flap

Plate 105 Cutaneous Trunci Myocutaneous Flap

Plate 106 Latissimus Dorsi Muscle Flap

Plate 107 Latissimus Dorsi Bipedicle Muscle Flap

Plate 108 Triceps Replacement with Latissimus Dorsi Muscle

Plate 109 External Abdominal Oblique Muscle Flap

Plate 110 Caudal Sartorius Muscle Flap

Plate 111 Cranial Sartorius Muscle Flap

Plate 112 Temporalis Muscle Flap

Plate 113 Transversus Abdominis Muscle Flap

Plate 114 Semitendinosus Muscle and Myocutaneous Flaps

Plate 115 Flexor Carpi Ulnaris Muscle Flap

Plate 116 Cranial Tibial Muscle Flap

Plate 117 Internal Obturator Muscle Flap

Plate 118 Superficial Gluteal Flap for Perineal Hernia Closure

17 Oral Reconstructive Surgical Techniques

INTRODUCTION

CLEFT PALATE

PALATAL DEFECTS/ORONASAL FISTULAS

MANDIBULECTOMY AND MAXILLECTOMY

GLOSSECTOMY

Plate 119 Mucosal Flaps

Plate 120 Palatoplasty: Bipedicle Advancement Technique (von Langenbeck Palatoplasty)

Plate 121 Cleft Palate Repair: Overlapping (Mucoperiosteal) Flap with Unilateral Bipedicle Flap

Plate 122 Extended Overlapping Flap Technique

Plate 123 Palatine Mucosal Flap

Plate 124 Soft Palate/Pharyngeal Mucosal Flaps

Plate 125 Full‐Thickness Labial Flap Closure of Oronasal Fistulas

Plate 126 Cartilage Grafts for Palatal Fistulas

Plate 127 Angularis Oris Mucosal Flap

Plate 128 Full‐Thickness Upper Labial Flap for Major Palatal Defects

Plate 129 Feline Superior Labial Musculomucosal Flap

Plate 130 Bilateral Myomucosal Advancement Flaps of the Upper Lip

Plate 131 Soft Palate Split‐Thickness Mucosal Flap

Plate 132 Partial Mandibulectomy Options

Plate 133 Partial Maxillectomy Options

Plate 134 Partial Glossectomy

18 Foot PadReconstruction

INTRODUCTION

PAD LACERATION AND LESION EXCISION

DIGITAL PAD TRANSFER

METACARPAL/METATARSAL PAD TRANSFER

ACCESSORY CARPAL PAD

PAD GRAFTING

DIGITAL FLAPS FOR WOUND CLOSURE

FUSION PODOPLASTY

Plate 135 Digital Flap Technique: Major Digital/Interdigital Defects

Plate 136 Digital Flap Technique: Major Defects of Digits Two or Five

Plate 137 Digital Pad Transfer

Plate 138 Metatarsal/Metacarpal Pad Transfer

Plate 139 Pad Grafting

Plate 140 Segmental Pad Grafting Technique

Plate 141 Fusion Podoplasty

19 Major Eyelid Reconstruction

INTRODUCTION

THE EYELIDS

Plate 142 Skin Flap Options for Cutaneous Defects of the Eyelid Regions

Plate 143 Lip‐to‐Lid Procedure

Plate 144 Oral Mucosal Graft onto Skin Flap

Plate 145 Third Eyelid–Skin Flap Reconstruction of the Lower Eyelid

Plate 146 Hubner Technique Using a Free Tarsomarginal Graft for Eyelid Reconstruction

20 Nasal Reconstruction

INTRODUCTION: NASAL ANATOMY

TRAUMATIC WOUND MANAGEMENT

NEOPLASIA

NEOPLASMS AND SURGICAL MARGINS

NASAL RECONSTRUCTION OPTIONS

OPTIONS FOR MANAGING NASAL STENOSIS

Plate 147 Septal Coverage Using Cutaneous Advancement Flaps

Plate 148 Bilateral Sulcus Flap Technique

Plate 149 Septal Resection Technique

Plate 150 Dorsal Nasal Splitting Technique to Enhance Exposure of Septum

Plate 151 Alar Fold Flaps

Plate 152 Musculofascial Island Labial Flap

Plate 153 Labial Mucosal Inversion Technique

Plate 154 Nasal Reconstruction (“Lip‐to‐Nose”) with the “Lip‐to‐Lid” Technique Variation

Plate 155 Nasal Reconstruction Using the “Lip‐to‐Nose” Technique in Cats

Plate 156 Oral Mucosal Graft with Nasal Stenting

Plate 157 Intranasal Septal Window Technique

Plate 158 Cantilever Suture Technique

Plate 159 Alar Fold Lift‐Up and Sulcus Pull‐Down Techniques for Feline Stenotic Nares

Plate 160 Alarplasty for Stenotic Nares in Brachycephalic Dogs

21 Cosmetic Closure Techniques

COSMETIC CONSIDERATIONS

CAUSES OF SCARS

MINIMIZATION OF SCARRING

DOG‐EARS

Plate 161 Scar Concealment

Plate 162 W‐Plasty

Plate 163 Dog‐Ear: Surgical Correction

22 Preputial Reconstructive Surgery

INTRODUCTION

SURGICAL CONDITIONS

SURGICAL TECHNIQUES

Plate 164 Preputial Ostium Enlargement

Plate 165 Preputial Ostium Reduction

Plate 166 Preputial Advancement Technique

Plate 167 Phallopexy

Plate 168 Urethral Reconstruction for Subanal Hypospadias

Plate 169 Preputial Urethrostomy Technique

Plate 170 Urine Diversion Technique

23 Pinnal Reconstructive Surgery

INTRODUCTION

ANATOMY OF THE PINNA

SURGICAL CONDITIONS

WOUND MANAGEMENT AND RECONSTRUCTIVE SURGICAL TECHNIQUES

AURAL HEMATOMA MANAGEMENT OPTIONS

Plate 171 Skin Advancement Closure: Rostral Pinnal Base

Plate 172 Skin Advancement Closure: Caudal Pinnal Base

Plate 173 Transposition Flap Technique for Smaller Medial Pinnal Defects

Plate 174 Transposition Flap Technique for Minor Lateral Pinnal Defects

Plate 175 Large Transposition Flap Closure after Major Medial Pinnal Resection

Plate 176 Transposition Flap for Major Lateral Pinnal Defects

Plate 177 Direct Flap Reconstruction of the Pinna

Plate 178 Resection of the Terminal Third of the Pinna

Plate 179 Inverted “Triangle” Resection of the Central Third of the Pinna

Plate 180 Central Pinna Defects: Closure Options

Plate 181 Partial Vertical Ear Canal Resection in Cats

Plate 182 Incisional Drainage of Aural Hematomas

Plate 183 Bandaging the Pinna

Plate 184 Vacuum Drain Management of Aural Hematomas

24 Miscellaneous Reconstructive Surgical Techniques

OMENTUM

SCROTUM

TAIL FOLD INTERTRIGO (SCREW TAIL)

DISORDERS OF THE VULVA

MANAGING SKIN FOLD INVERSION OF URETHROSTOMIES

FECAL INCONTINENCE: TREATMENT OPTIONS

ATRESIA ANI RECONSTRUCTION

Plate 185 Omental Flap Options

Plate 186 Alternative Method for Omental Flap Extension Based on Circulation

Plate 187 Scrotal Flap Technique

Plate 188 Caudectomy for Tail Fold Intertrigo

Plate 189 Episioplasty

Plate 190 Fascia Lata Sling and Silicone Banding for Managing Fecal Incontinence

Plate 191 Spiral Rectal Diaphragm Technique (Rectal Rifling)

Plate 192 Vulva Fold Skin Flap

Plate 193 Type II Atresia Ani Repair

Plate 194 Type II Atresia Ani with Rectovaginal Fistula Repair

Plate 195 Type III Atresia Ani Repair

25 Extras

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