Spike's Skin Graft

Skin grafts are not commonly done in veterinary practice but we have been doing them regularly at Loving Hands.  When a kitten lost the covering on one leg in a losing battle with the fan belt of a car a skin graft was done to replace what was lost.  That story is told in a note from Tom Denham.  We have been doing an increasing number of skin grafts to deal with wounds from the removal of tumors.  [Note: These typically are a result of watching a suspicious lump too long rather than just taking it off.  Since we began using a laser at Loving Hands we have become very aggressive about recommending the removal of suspicious lumps rather than watching them.  Not all doctors are this aggressive and while most of the time lumps are no big deal, sometimes they are cancerous and the waiting allows cancer to spread and cause more extensive damage.]

Just so you understand, this patient is Spike Westin.  She belongs to Angela and David Westin.  Spike was born in Kentucky May 1989, a University of Louisville Cardinal Fan. She was the runt of the litter and didn't want to come out from under the neighbor’s house.  However, she was so cute the Westin's just had to have her.  Spike is now fully in charge of the house. She has her own room and her own couch. She loves to have her tummy rubbed and definitely loves to eat.  When Angela and David leave for work, they have to leave Animal Planet on TV for her. If they fail to put the TV on the correct channel, she barks at them until they correct the error. Spike's favorite activities are sleeping, chasing squirrels, watching TV (Animal Planet and Braves baseball), and sleeping.

Spike had a mast cell tumor on her lower leg.  Because the tumor was cancerous it was necessary to remove a large amount of skin and tissue around the site.  The resulting wound was so large it could not be sutured closed.

Two weeks after the tumor removal surgery was completed, the skin graft process was begun.  Two incisions were made to free up a flap of skin on Spike's thigh.  The skin was left attached at the top and bottom.  

The edges of the skin were pulled together under the flap to close the opening in the thigh.  Then the edges of the skin on the flap were pulled together to form a tube.  Spike looked sort of like she had a handle on her thigh at this point.

After two more weeks it was time for the next step.  Spike is under anesthesia here and is being monitored with a pulse oximeter to measure heart rate and oxygen level in the blood.  Notice the clip attached to the big pink tongue.  [Brandee Sass was asked to play Vanna White for this picture as the procedure is begun.]

Spike is wet because Brandee had just completed doing hydrotherapy and cleansing on the wound and graft site prior to beginning surgery.

After a new blood supply to the skin flap had developed, the top part of the "handle" was severed and the sutures were removed from the tube.  This yielded a healthy piece of skin that was still attached to a blood supply through the thigh.  This section was rotated down onto the original wound site and sutured in place.

This may look ugly to you but to a surgeon it is looking good.  This procedure was done on August 7, 2000.  

Spike came back four days after surgery for a recheck.  Is it any wonder why her owners would want to take such good care of her?

August 23rd, after a new blood supply to the skin graft had developed.  About 75% of the graft has lived.  This is a success.  It will start to look better soon.

This is the graft site September 14th.  The last section of the "handle" has just been removed and this should be the last piece of work done on Spike's graft.

Spike has longer hair on a section of her leg than she did before and it lies in the wrong direction compared to the rest.  But skin grafting sped up the healing process of the wound and provided a more attractive result than what would have been possible by bandaging the wound and hoping for the best.

PS: We would have used leeches in the course of treating Spike but her owners did not like the idea.  Leeches actually provide medical benefits in some situations that surpass the value of modern medicine.  LeechesUSA is a website that provides orientation to the use of leeches in medicine.