As my colleague Terry Dunne described in his article on surgical excision of tumours -
"Amy" - Cat with Cutaneous Haemangiosarcoma. The key to a successful outcome is to remove as wide a normal margin of healthy tissue as possible from around the diseased area.

The main difficulties arise where these margins are compromised by the location of the mass. However, sometimes we need to do surgery on areas of the body where there is a lot of traction or tension already on the skin (e.g., head, distal part of the legs, feet...). In these cases we need to release tension by “creating” more skin to enable us to close the wound.

Such a procedure was performed on Lucy, a beautiful German shepherd dog which had a tumour near her lower eyelid. A normal excision of the tumour with reasonable margins would cause an ectropion (pulling down of lower eyelid) caused by traction leaving her looking more like a Basset Hound than a german Shepherd dog. Therefore, full thickness skin graft surgery had to be performed.

Making a long incision parallel to the eye margin and a triangular incision perpendicular to the first one allowed me to remove the tumour. To close the wide triangular gap, I needed to undermine the adjacent skin and I had to excise small triangles at both ends of the first long incision to perform a skin flap slide. In this way, some spare skin from the cheek and the nose dorsum is used to close the initial wound.As the wound is very close to the eye, I used intra-dermal sutures.

The final result is a patient who is not only cured from their tumour but still retains their good looks..........an excellent combination!

Michele Lampens MRCVS

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