Introduction

• The goal of wound reconstruction is to return the patient to normal activity levels and function, ideally with minimal cosmetic impact although function should never be sacrificed simply to obtain better cosmesis. Knowing when and how to close a particular wound mandates understanding the factors that influence wound healing. Understanding these influences on wound healing will allow the veterinary surgeon to correctly select the best method of reconstruction but also - more importantly - to avoid using the wrong approach or misusing the correct one.

Factors influencing wound healing

Wound closure options

Primary wound closure

Reconstructive surgical techniques for skin

Skin stretching and skin expansion

Further Reading

Publications

Refereed papers

• Recent references from PubMed and VetMedResource.
• De Lorenzi M, Swan M C, Easter C et al (2018) Outcome of reconstruction of cutaneous limb defects in dogs using hygroscopic "self-inflating" tissue expanders. JSAP 59 (2), 98-105 PubMed.
• Miller A J, Cashmore R G, Marchevsky A M et al (2016) Negative pressure wound therapy using a portable single use device for free skin grafts on the distal extremity in seven dogs Aust Vet J 94 (9), 309-316 PubMed.
• Riggs J, Jennings J L, Friend E J et al (2015) Outcome of full-thickness skin grafts used to close skin defects involving the distal aspects of the limbs in cats and dogs: 52 cases (2005–2012). J Am Vet Med Assoc 247 (9), 1042-1047 PubMed.
• Tsioli V, Papozoglou L G, Papaioannou N et al (2015) Comparison of three skin-stretching devices for closing skin defects on the limbs of dogs. J Vet Sci 16 (1), 99-106 PubMed.
• Handschel J, Schultz S, Depprich R et al (2013) Tissue expanders for soft tissue reconstruction in the head and neck area - requirements and limitations. Clin Oral Investig 17 (2), 573-578 PubMed.
• Holt D & Runge J (2011) Use of Skin Stretchers to Elongate a Peninsular Thoracodorsal Axial Pattern Flap for Antebrachial Wound Closure in a Dog. Vet Surg 40 (3), 352-356 PubMed.
• Pavletic M M (2000) Use of an external skin-stretching device for wound closure in dogs and cats. J Am Vet Med Assoc 217 (3), 350-354 PubMed.

Other sources of information

• Morris C & Lloyd T (2017) A new nose for Greyhound. Vet Times, April 3 2017.
• Khosh MM (2016) Tissue Expansion. Medscape http://emedicine.medscape.com/article/880686-overview.
• Various authors (2012) Section V: Skin and Reconstruction.  In: Veterinary Surgery, Small Animal, Vol 2. 1st Edn.  Eds: Tobias K M &Johnston S A.  Elsevier Saunders, Missouri, USA.  pp 1197 - 1302.
• Pavletic M M (2010) Atlas of Small Animal Wound Management and Reconstruction. Third Edn.  Wiley Blackwell, Iowa, USA. 
• www.oxtex.com
• www.expaniderm.com