Skin grafting in a dog

History: The dog brought with history of vesicant burn in the leg which was not taken care and leads to infection and necrosis of the skin of lateral aspect of the thigh region of the right leg. See image above.

Treatment: I advice the owner to bring the dog for debridement of the wound to make it fresh. Then fixed the surgery.

Discussion:  A skin graft is a piece of skin that has been totally removed from the body and placed on a wound. Blood vessels in the wound bed will quickly grow into the underside of the skin graft, thus bringing it back to life. If the blood vessels cannot grow quickly enough into the the underside of the skin graft, the graft will die. For this reason the wound must be adequate to nutritionally support the graft and the surgeon must very carefully prepare the skin graft so that vessels will be able to grow into the graft.

Indication:

• Skin grafts are used for wounds that are caused by
  • traumatic accidents
  • oncological surgery (tumor removal)
  • thermal burns
  • chemical burns
  • vesicant burns - injected medications such as chemotherapeutic medications or some injectable anesthetics
• The procedure has the advantage of requiring only one surgery once the wound bed is adequately prepared for grafting.

Types of skin grafts that are used to repair the wounds:

• Full-thickness skin grafts are most commonly used in dogs and cats. This involves removing the a piece of skin and removing the fat from the underside of the skin. The donor site must have enough surrounding loose skin so that the incision can be closed. The survival ("take") of a full-thickness skin graft is the same as a partial-thickness skin graft.
• Partial-thickness skin grafts skin grafts involve shaving a very thin layer of skin off the donor site. No hair will grow from this skin graft because the hair follicles are in the deeper layers of the skin. The donor site will heal on its own and does not involve closure of an incision. This type of graft donor site can be more painful, as the raw donor site will have many exposed nerve endings that need to heal over with time. The indication for partial thickness skin grafting is for cases in which a dog has massive skin loss (especially a burn victim) and there is limited normal skin that is available to be used for skin grafting.

Care at home after surgery:

•  Limit activity for 3 weeks after surgery
•  Keep the bandage dry
• Check the toes for swelling and coldness if the graft site is on a limb (while the bandage is on)
•  Return to veterinarian at the scheduled times for bandage changes
• After the bandage is no longer needed, cover the graft site with a soak (if the graft site is on a limb) for a period of 3 to 4 weeks to prevent your pet from licking and chewing at the site. If needed, an Elizabethan collar may be recommended to prevent self-mutilation.

Reference: http://www.vetsurgerycentral.com/skin_grafts.html