Reconstructive Surgery

Gary Lewin CertVOphthal CertSAS is one of very few veterinary surgeons in the United Kingdom who has undergone training in advanced microvascular surgery and at the Paragon Veterinary Group we have the facilities to offer referral service in microvascular reconstructive surgery. 

Microvascular skin grafts can be particularly useful in the management of distal limb wounds and micro-vascular skin or skin-muscle composite grafts can be used in cases of tumour excision where there has been en-bloc resection and significant loss of both the skin and underlying tissuesn site.

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End to end anastamosis of arteries 1.1mm diameter

Microvascular free tissue transfer is the transfer of tissue or tissues, supplied by single artery and vein, (an angiosome) to a distant site.   Microvascular anastamosis of the artery and vein supplying the angiosome to blood vessels at the recipient site maintains a blood supply to the transposed tissue and enables the transposition of large blocks of tissue to a distant site. This can enable a repair of significant soft tissue defects that are not otherwise amenable to repair by local tissue transfer in a single step procedure.

Microvascular surgery may be indicated in cases if severe tissue loss such as trauma or tumour excision. The vascularised graft is more tolerant of sub-optimal conditions than a free non-vascularised graft would be and will tolerate the presence of infection and the absence of under-lying vascularised tissues. The graft may be transposed in cases where infected or devitalised tissues or exposed bone are present.

 

Case Study

1. Extensive forelimb skin loss following an acute cellulitis	2. Caudal superficial epi-gastric angiosome has been transposed to repair the defect and anastamosed to the brachial artery and vein
3. The graft two weeks post-operatively	4. The appearance of the graft three month's post-operatively