Buddy is a yellow Labrador that was hit by a mail delivery truck and sustained severe shearing injuries to both pelvic limbs. His soft tissue deficit was protected after light wound debridement with application of sterile AMD gauze applications until a confluent bed of healthy granulation tissue was present. At that time, a full thickness skin graft, harvested from his flank was transferred to the granulation tissue bed.
Shearing injuries are common in dogs that are hit by a car. Despite the initial appearance of the injury, the outcome can be favorable if vital neuromas ulnar structures are intact. While the degree of skin loss can be extensive, this deficit can be overcome with open wound management and grafting technique.
When presented with a shearing injury, assess the neurovascular status of the limb to determine the suitability for a reconstructive procedure. In some instances, the viability of the limb cannot be determined at the time of presentation. A strategy of open wound management with sterile dressing changes and serial assessments of sensation and perfusion is formulated. When the neurovascular status is severely compromised, amputation may be indicated.
When the cutaneous deficit exceeds the amount normal skin can contract and heal by second intension healing, a skin graft is useful to provide a mechanically durable cutaneous surface.
Buddy experienced rapid healing of the grafted tissue. Completion of his recovery was hampered by his innate drive to lick the wound, resulting in the occasional setback to the regions of injury healing by second intention healing.
- Outcome is dictated by neurovascular damage rather than skin loss.
- Wound management is based on the character of the wound and extent of tissue loss.
- The caregiver’s role should not be over looked.