Research Updates: Using a scrotal mesh graft to repair degloving injuries
The results of this study provide support for various treatment strategies based on clinical presentation, owner finances, and the clinician's competency.
Degloving injury, secondary to trauma, is a common clinical problem in veterinary patients. Occurring most frequently on the distal limbs, these wounds can cause a high degree of morbidity because of damage and exposure of underlying tissues, including muscles, tendons, ligaments, bones, and joints. To repair large skin defects, free and pedicle grafts are used; smaller wounds are allowed to heal by second intention and re-epithelialization.
Joseph Harari
This clinical report from a surgery referral practice in southern California describes the successful treatment of two intact male dogs under 2 years old with distal limb degloving injuries with full-thickness mesh skin grafts obtained by scrotal ablation castration. One dog was treated for four weeks and the other for one week with wet-to-dry bandages to develop a healthy granulation tissue bed. Routine scrotal ablation castration was then performed, and a mesh graft was created; this tissue was applied to the injured recipient site and covered with a nonadherent dressing.
New bandages were applied multiple times until day 13. One dog had 100% graft take by day 11, and the other had 90% graft take by day 9. Both dogs had acceptable function and cosmesis by days 30 and 47 after skin grafting surgery. The authors concluded that scrotal grafting was a useful option for distal limb degloving injuries. The authors state that further evaluation is needed to determine whether scrotal remnant grafting could be performed in previously neutered dogs.
COMMENTARY
The goal of treating distal limb degloving injuries is to reduce wound contamination or infection and to restore anatomical structures and adequate limb function. In this report, the authors have provided a novel approach to obtaining an autogenous mesh graft, which, although limited to young, healthy, intact male dogs, seems successful and technically easy to perform. Furthermore, neutering would eliminate or reduce unnecessary breeding, fighting, or health issues (scrotal neoplasia, prostatitis) related to an intact status.
Harris JE, Dhupa S. Treatment of degloving injuries with autogenous full thickness mesh scrotal free grafts. Vet Comp Orthop Traumatol 2008;21(4):378-381
The information in "Research Updates" was provided by Veterinary Medicine Editorial Advisory Board member Joseph Harari, MS, DVM, DACVS, Veterinary Surgical Specialists, 21 E. Mission Ave., Spokane, WA 99202.
