What Is a Skin Reconstruction?
Severe and large wounds can occur in pets. These wounds are usually created by trauma, such as being hit and dragged by a car, or they may be associated with burns, gunshots or animal bites. The wounds can also be created after the removal of a large tumor where there is insufficient skin to close the defect. Skin reconstruction is the surgical procedure used to repair major skin loss or defects.
What Are the Indications for Performing a Skin Reconstruction?
Skin reconstruction is indicated anytime there is a large area of skin loss than cannot be sutured together.
What Preoperative Examinations or Tests Are Needed Before a Skin Reconstruction?
Preoperative tests depend in part on the age and general health of the animal as well as the cause of the skin reconstruction. Most often, blood count, serum biochemical tests and a urinalysis is performed. In the case of severe trauma or tumor removal, more extensive tests such as radiographs or EKG may be necessary.
What Type of Anesthesia is Needed For a Skin Reconstruction?
As in a human patient, the procedure in dogs and cats requires general anesthesia to induce complete unconsciousness and relaxation. In the usual case, the pet will receive a pre-anesthetic sedative-analgesic drug to help him relax, a brief intravenous anesthetic to allow placement of a breathing tube in the windpipe, and subsequently inhalation (gas) anesthesia in oxygen during the actual surgery.
How Is the Skin Reconstruction Operation Done?
Following anesthesia, the pet is placed on a surgical table with the injured area exposed. The hair is clipped around the area of the skin loss and scrubbed with surgical soap to disinfect the area. A sterile drape is placed over the surgical site. At this point, there are several surgical options available, depending on the severity of skin loss and the site on the body.
If closure of the skin will cause tightness or a lot of tension, a special pattern of sutures can be used to hold the skin edges together. If areas of loose skin can be raised, then a flap of skin can be rotated from the edge of the wound. If the loose skin is located on a part of the body not near the wound, a skin graft can be performed. This involved the complete removal of the skin and placing on the wound area.
Following these procedures, sutures (stitches) that dissolve over time are used to close the deeper tissue layers, if necessary. The outer layer of skin is closed as best as possible with sutures or surgical staples; these need to be removed in about 10 to 14 days.
If any of these reconstructive techniques result in only partial closure of the wound, then the rest of the wound may be able to heal by scarring or further reconstructive surgery may be necessary.
How Long Does the Skin Reconstruction Take to Perform?
The procedure takes about 60 minutes to two hours to perform in most cases, including the needed time for preparation and anesthesia. In extensive skin loss, the procedure can take longer and may require the expertise of a board certified surgeon.
What Are the Risks and Complications of a Skin Reconstruction Operation?
The overall risk of this surgery is moderate. The major risks and are those of general anesthesia, bleeding (hemorrhage), postoperative infection and wound breakdown (dehiscence) over the incision. Overall complication rate is moderate, but serious complications can result in death or the need for additional surgery.
What Is the Typical Postoperative Aftercare For Skin Reconstruction?
Postoperative medication should be given to relieve pain, which is judged in most cases to be mild to moderate and can be effectively eliminated with safe and effective pain medicines. The home care requires reduced activity until the stitches are removed in 10 to 14 days. The suture line and wound area should be inspected daily by the pet owner for signs of redness, discharge, swelling, or pain. If the wound area was not completely closed, topical medications may be necessary. It is imperative that the pet not be allowed to lick or chew at the surgery site.
How Long Is the Hospital Stay Following Skin Reconstruction?
The typical stay for skin reconstruction is 3-5 days but will vary depending on overall health of the pet.