%0 Journal Article
%T Vacuum-Assisted Closure Combined with a Myocutaneous Flap in the Management of Osteomyelitis in a Dog
%A Jeremy L. Shomper
%A Julia V. Coutin
%A Otto I. Lanz
%J Case Reports in Veterinary Medicine
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/689415
%X Case Description. A 2.5-year-old female spayed mixed breed dog presented to the Teaching Hospital for draining tracts on the left medial aspect of the tibia. Two years prior to presentation, the patient sustained a left tibial fracture, which was repaired with an intramedullary (IM) pin and two cerclage wires. Multiple antimicrobials were utilized during this time. Clinical Findings. Radiographs were consistent with left tibial osteomyelitis. The implant was removed and the wound was debrided. Treatment and Outcome. A bone window on the medial aspect of the tibia was created in order to facilitate implant removal. The wound and associated bone window were treated with vacuum assisted closure (VAC) in preparation for reconstructive surgery. Adjunctive VAC therapy was utilized following the caudal sartorius myocutaneous flap. Complications following this surgery included distal flap necrosis and donor site dehiscence. Clinical Relevance. This presents a difficult case of canine osteomyelitis with subsequent wound care in which VAC and a myocutaneous flap were useful adjunctive treatments for osteomyelitis. This is the first report of VAC in the management of canine osteomyelitis and management with a myocutaneous flap. 1. Introduction Muscle is the most versatile tissue for reconstructive surgery and is used in a variety of reconstructive surgical procedures ranging from soft tissue to orthopedics. Muscle flaps, for the most part, are easily dissected and are harvested with little donor site morbidity [1]. Donor muscle selection is based on the dimensions of the defect and function or purpose of the reconstructive procedure and can be harvested alone or as a composite flap (skin and muscle) [2¨C4]. Muscle flaps augment vascular supply of compromised wounds by inducing angiogenesis, which is used for the management of chronic osteomyelitis, shearing wounds to the distal extremities, decubital ulcers, and ablative oncological procedures [3¨C5]. The increased blood supply through transferred muscle enhances the host defense mechanism to a compromised wound by increasing local concentrations of immunoglobulins, complement, neutrophils, and oxygen tension [2, 6]. The use of vacuum assisted closure (VAC) therapy is well described as an alternative strategy in the management of a variety of wounds encountered in human medicine and surgery [7¨C11]. The uses of VAC therapy in human surgery include decubital ulcers, degloving injuries, distal extremity wounds, as a means to secure split thickness skin grafts in anatomically challenging areas, poststernotomy dehiscence
%U http://www.hindawi.com/journals/crivem/2013/689415/