Degloving Wound Management By Second-intention Healing

Discussion in 'Veterinary Discussion' started by Admin, Mar 29, 2017.

By Admin on Mar 29, 2017 at 10:49 AM
  1. Admin

    Admin Administrator Staff Member

    Caleb Hudson, DVM, MS, DACVS (Small Animal), Gulf Coast Veterinary Specialists, Houston, Texas
    Karen Theresa Ellis, LVT, VTS (Surgery), Gulf Coast Veterinary Specialists, Houston, Texas

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    Case Summary
    Caleb Hudson, DVM, MS, DACVS (Small Animal), Gulf Coast Veterinary Specialists, Houston, Texas

    Rosie, a 6-month-old spayed female Chihuahua mix, presented for evaluation after being hit by a car several hours earlier. No systemic abnormalities were noted. Physical examination disclosed a large degloving injury over her right forelimb proximal to the carpal joint and extending distally to the tips of the phalanges.


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    FIGURE 1 Degloving wound at initial presentation with exposure of the third metacarpal bone. Photo courtesy of Dana Gale, DVM

    The wound involved approximately 50% of the distal limb circumference and consisted of full-thickness soft- tissue loss on the dorsal aspect of the metacarpus with exposure of the second, third, and fourth metacarpal bones. (See Figure 1.) The carpal and digital pads were intact. Palpation of the distal right forelimb elicited instability and crepitus in the wound region, and right forelimb radiographs showed fractures of the third, fourth, and fifth metacarpal bones and the first phalange of digit 3. Carpal palpation revealed no evidence of varus or valgus instability, indicating the carpal collateral ligaments were intact. Thoracic radiographs disclosed clear lung fields and a normal-sized cardiac silhouette with no evidence of pulmonary contusions.

    Surgical debridement was indicated, and Rosie was premedicated with hydromorphone and midazolam. Anesthesia was induced using propofol and maintained using isoflurane inhalant anesthesia. The degloving wound was flushed thoroughly with sterile saline and surgically debrided. A tissue sample was collected from the wound site and submitted for bacterial culture and susceptibility testing.

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Discussion in 'Veterinary Discussion' started by Admin, Mar 29, 2017.

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