Atlas of Animal Wound Management and Reconstructive Surgery 4th edition
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Atlas of Animal Wound Management and Reconstructive Surgery 4th edition

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Wound management and reconstructive surgery are among the most challenging and innovative subspecialties of veterinary surgery for the management of traumatic injuries and neoplastic conditions commonly encountered in small animals. Atlas of Small Animal Wound Management and Reconstructive Surgery, Fourth Edition presents detailed procedures for surgical reconstruction and essential information on the principles of wound healing and wound management for dogs and cats. Coverage encompasses the pathophysiology and management of the wide variety of wounds encountered in small animal practice and the most current reconstructive techniques for closing the most challenging defects.

Michael M. Pavletic, DVM, Diplomate ACVS

Director of Surgical Services at Angell Animal Medical Center in Boston, Massachusetts, USA.

Foreword

Preface

Acknowledgments

About the Companion Website

1. The Ski

Skin Functio

Skin Structur

Cutaneous Adnex

The Hypodermi

Cutaneous Circulatio

Pinna: Cutaneous Considerations

Congenital Skin Disorders

2. Basic Principles of Wound Healing

Introduction

Wound Healing

Acute Versus Chronic Open Wounds

Species Variations in Wound Healing

“Artificial Skin”

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 (NPWT)

Concept of Moist Wound Healing (MWH)

Topical Wound Care Products

The Maggot and Leach 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 Layer

Dressings: The Secondary Layer

Dressings: The Tertiary 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: Elasticon 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

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 Great Trochanter

Plate 12: Vacuum Drain Management of Elbow Hygromas

8. Regional Considerations

The Canine and Feline Profiles

Plates 13A and 13B: 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

10. Skin‐Stretching Techniques

Physiology of Skin Stretching

Presuturing

Load Cycling

Skin Stretchers

Skin Expanders

Plate 34: Presuturing Technique

Plate 35: Application of Skin Stretchers

Plate 36: Skin Stretchers to Enhance Length of Axial Pattern Flaps

Plate 37: Skin Stretcher Substitution for Presuturing

Plate 38: Skin Expanders

11. Local Flaps

Introduction

Advancement Flaps

Rotating (Pivoting) Flaps

Plate 39: Single Pedicle Advancement Flap

Plate 40: Bipedicle Advancement Flap

Plate 41: Transposition Flap (90 degrees)

Plate 42: Transposition Flap (45 degrees)

Plate 43: Transposition Flap (Oblique Angle)

Plate 44: Local Facial Flap Options vs. Auricular Axial Pattern Flap

Plate 45: Transposition Flaps in Partial Wound Closure

Plate 46: Interpolation Flap

Plate 47: Rotation Flap

Plate 48: Forelimb Fold Flap

12. Distant Flap Techniques

Distant Flaps

Direct Flaps

Indirect Flaps

The Delay Phenomenon

Plate 49: Direct Flap: Single Pedicle (Hinge) Flap

Plate 50: Direct Flap Closure of Knee Defect

Plate 51: Direct Flap: Bipedicle (Pouch) Flap

Plate 52: 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

Plate 53: Four Major Axial Pattern Flaps of the Canine Trunk

Plate 54: Skin Position and Axial Pattern Flap Development

Plate 55: Omocervical Axial Pattern Flap

Plate 56: Thoracodorsal Axial Pattern Flap

Plate 57: Lateral Thoracic Axial Pattern Flap

Plate 58: Superficial Brachial Axial Pattern Flap

Plate 59: Caudal Superficial Epigastric Axial Pattern Flap

Plate 60: Cranial Superficial Epigastric Axial Pattern Flap

Plate 61: Deep Circumflex Iliac Axial Pattern Flap: Dorsal Branch

Plate 62: Deep Circumflex Iliac Axial Pattern Flap: Ventral Branch

Plate 63: Flank Fold Flap: Hind Limb

Plate 64: Genicular Axial Pattern Flap

Plate 65: Reverse Saphenous Conduit Flap

Plate 66: Caudal Auricular Axial Pattern Flap

Plate 67: Superficial Temporal Axial Pattern Flap

Plate 68: Lateral Caudal (Tail) Axial Pattern Flap

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

Use of Plates

Plate 69: Punch Grafts

Plate 70: Pinch Grafts

Plate 71: Strip Grafts

Plate 72: Stamp Grafts

Plate 73: Sheet Grafts

Plate 74: Dermatome: Split‐Thickness Skin Graft Harvesting

Plate 75: Mesh Grafts (With Expansion Units)

Plate 76: Mesh Grafts (With Scalpel Blades)

15. Facial Reconstruction

Introduction: Facial Reconstructive Surgery

Plate 77: Repair of Upper Lip Avulsion

Plate 78: Repair of Lower Labial Avulsion

Plate 79: Wedge Resection Technique

Plate 80: Rectangular Resection Technique

Plate 81: Full‐Thickness Labial Advancement Technique (Upper Lip)

Plate 82: Full‐Thickness Labial Advancement Technique (Lower Lip)

Plate 83: Buccal Rotation Technique

Plate 84: Lower Labial Lift‐Up Technique

Plate 85: Upper Labial Pull‐Down Technique

Plate 86: Labial/Buccal Reconstruction with Inverse Tubed Skin Flap

Plate 87: Skin Flap for Upper Labial and Buccal Replacement (Facial [Angularis Oris] Axial Pattern Flap)

Plate 88: Feline Facial Axial Pattern Flap

Plate 89: Cleft Lip Repair (Primary Cleft, Cheiloschisis, Harelip)

Plate 90: Unilateral Rostral Labial Pivot Flaps

Plate 91: Bilateral Rostral Labial Pivot Flaps

Plate 92: Oral Commissure Advancement Technique

Plate 93: Brachycephalic Facial Fold Correction

Plate 94: Cheilopexy Technique for Drooling

16. Myocutaneous Flaps and Muscle Flaps

Introduction

Myocutaneous Flaps

Muscle Flaps

Plate 95: Latissimus Dorsi Myocutaneous Flap

Plate 96: Cutaneous Trunci Myocutaneous Flap

Plate 97: Latissimus Dorsi Muscle Flap

Plate 98: Latissimus Dorsi Bipedicle Muscle Flap

Plate 99: Triceps Replacement with Latissimus Dorsi Muscle

Plate 100: External Abdominal Oblique Muscle Flap

Plate 101: Caudal Sartorius Muscle Flap

Plate 102: Cranial Sartorius Muscle Flap

Plate 103: Temporalis Muscle Flap

Plate 104: Transversus Abdominis Muscle Flap

Plate 105: Semitendinosus Muscle and Myocutaneous Flaps

Plate 106: Flexor Carpi Ulnaris Muscle Flap

Plate 107: Cranial Tibial Muscle Flap

Plate 108: Internal Obturator Muscle Flap

Plate 109: Superficial Gluteal Flap for Perineal Hernia Closure

17. Oral Reconstructive Surgical Techniques

Introduction

Cleft Palate

Palatal Defects/Oronasal Fistulas

Plate 110: Mucosal Flaps

Plate 111: Palatoplasty: Bipedicle Advancement Technique

Plate 112: Cleft Palate Repair: Mucoperiosteal Flap Technique

Plate 113: Palatine Mucosal Flap

Plate 114: Soft Palate/Pharyngeal Mucosal Flaps

Plate 115: Full‐Thickness Labial Flap Closure of Oronasal Fistulas

Plate 116: Cartilage Grafts for Palatal Fistulas

Plate 117: Angularis Oris Mucosal Flap

18. Foot Pad Reconstruction

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 118: Digital Flap Technique: Major Digital/ Interdigital Defects

Plate 119: Digital Flap Technique: Major Defects of Digits Two or Five

Plate 120: Digital Pad Transfer

Plate 121: Metatarsal/Metacarpal Pad Transfer

Plate 122: Pad Grafting

Plate 123: Segmental Pad Grafting Technique

Plate 124: Fusion Podoplasty

19. Major Eyelid Reconstruction

Introduction

The Eyelids

Plate 125: Skin Flap Options for Cutaneous Defects of the Eyelid Regions

Plate 126: Lip‐to‐Lid Procedure

Plate 127: Oral Mucosal Graft onto Skin Flap

Plate 128: Third Eyelid–Skin Flap Reconstruction of the Lower Eyelid

20. Nasal Reconstruction Techniques

Introduction: Nasal Anatomy

Traumatic Wound Management

Neoplasia

Neoplasms and Surgical Margins

Nasal Reconstruction Options

Options for Managing Nasal Stenosis

Plate 129: Septal Coverage Using Cutaneous Advancement Flaps

Plate 130: Bilateral Sulcus Flap Technique

Plate 131: Septal Resection Technique

Plate 132: Dorsal Nasal Splitting Technique to Enhance Exposure of Septum

Plate 133: Alar Fold Flaps

Plate 134: Musculofascial Island Labial Flap

Plate 135: Labial Mucosal Inversion Technique

Plate 136: Nasal Reconstruction with the “Lip‐to‐ Lid Technique” Variation

Plate 137: Oral Mucosal Graft with Nasal Stenting

Plate 138: Intranasal Septal Window Technique

Plate 139: Cantilever Suture Technique

21. Cosmetic Closure Techniques

Cosmetic Considerations

Causes of Scars

Minimization of Scarring

Dog Ears

Plate 140: Scar Concealment

Plate 141: W‐Plasty

Plate 142: Dog Ear: Surgical Correction

22. Preputial Reconstructive Surgery

Introduction

Surgical Conditions

Surgical Techniques

Plate 143: Preputial Ostium Enlargement

Plate 144: Preputial Ostium Reduction

Plate 145: Preputial Advancement Technique

Plate 146: Phallopexy

Plate 147: Urethral Reconstruction for Subanal Hypospadias

Plate 148: Preputial Urethrostomy Technique

Plate 149: 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 150: Skin Advancement Closure: Rostral Pinnal Base

Plate 151: Skin Advancement Closure: Caudal Pinnal Base

Plate 152: Transposition Flap Technique for Smaller Medial Pinnal Defects

Plate 153: Transposition Flap Technique for Minor Lateral Pinnal Defects

Plate 154: Large Transposition Flap Closure After Major Medial Pinnal Resection

Plate 155: Transposition Flap for Major Lateral Pinnal Defects

Plate 156: Direct Flap Reconstruction of the Pinna

Plate 157: Resection of the Terminal Third of the Pinna

Plate 158: Inverted “Triangle” Resection of the Central Third of the Pinna

Plate 159: Incisional Drainage of Aural Hematomas

Plate 160: Bandaging the Pinna

Plate 161: 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

Plate 162: Omental Flap Options

Plate 163: Scrotal Flap Technique

Plate 164: Caudectomy for Tail Fold Intertrigo

Plate 165: Episioplasty

Plate 166: Fascia Lata Sling and Silicone Banding for Managing Fecal Incontinence

Plate 167: Spiral Rectal Diaphragm Technique (Rectal Rifling)

Index

9781119267508
  • Idioma Inglés
  • Autor/es Michael M. Pavletic
  • Año de edición 2018
  • Nº Páginas 880
  • Encuadernación Hard cover
  • Tamaño 22'1 X 28'4
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