Surgical management of a forelimb wound in a two year old Miniature Pinscher

A two year old castrated male Miniature Pinscher, presented to the Cornell University Hospital for Animals Triage Service on 8/5/06 with a history of being hit by a car on 8/4/06. Significant findings on presentation included pain, bradycardia, multiple fractures, and a large degloving wound over his right forelimb. He was treated with analgesics and antibiotics, underwent surgical fixation of a left acetabular fracture, and his left femoral head and neck were excised. His forelimb wound was managed with mechanical and surgical debridement as a healthy bed of granulation tissue formed. A full-thickness meshed skin graft was placed over the wound on the right dorsal pes and a thoracodorsal axial pattern island flap was harvested and rotated to cover the wound over the cranial aspect of the proximal right forelimb. The skin graft was very successful. However, due to necrosis and trauma sustained by the distal flap, three additional surgical procedures were necessary to close the remaining defect by direct apposition. The lack of redundant skin over the canine limb often necessitates the use of advanced reconstructive surgical techniques in successful management of extensive extremity wounds. Procedures, such as skin grafting and axial pattern flap placement, can be performed with relatively little advanced training and specialized equipment cost. However, the use of these procedures to achieve a functional and cosmetically appealing outcome does require owner and veterinarian commitment to intense wound management both pre and post-operatively