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Végtag distalis bőrhiányának pótlása teljes vastagságú hálószerű autografttal macskában - Esetleírás

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MAL 2019 12 735 (3.909Mb)
Date
2019-12
Author
Hegyi, Alexandra
Dunay, Miklós Pál
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Abstract
SUMMARY Background: Skin grafting is especially useful in the management of wound involving the distal part of the limb, where local transfer of tissue is impossible. Indications of this surgical technique are skin defects which result from traumatic shearing injuries, surgical resections of large tumours or burn. Skin grafts are categorized according to their host donor relationship and by their thickness. Meshing the graft is an important factor for survival, prevents the accumulation of serum or blood under the graft, and provides more flexibility over uneven surfaces, ensuring that good contact between the graft and the recipient bed is maintained. Materials and Methods: A 6-year-old neutered cat arrived at our clinic with a traumatic injury on the left front limb. After debridement we decided to bandage the leg as long as needed and after to reconstruct the skin with an autogenous mesh graft. We performed the surgery on the 15th day, by then healthy granulation tissue has formed. Full-thickness skin were harvested from the lateral abdominal region, where abundant loose skin was available and the area could be closed primarily. The size of the graft and the direction of hair growth were noted. Before implantation subcutaneous fat was completely removed from the graft with scissors and incisions were made on it (meshing). We applied the graft to the recipient site with interrupted suture pattern using nonabsorbable, monofilament material. After surgery we used a special, two component band-age, which was changed on the fourth day.Results and Discussion: Approximately 90% of the graft remained viable. We saved the limb and despite of toe amputations the cat is able to walk with min-imal lameness. Cosmetic outcome of the surgery is acceptable with minor alterations (hair is longer and lighter in colour). Successful grafting requires asepsis, an adequately prepared recipient bed consisting of healthy granulation tissue, proper harvesting and preparation of the graft, meticulous surgical technique and strict postoperative care.
URI
http://hdl.handle.net/10832/2621
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