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Open wound healing
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Open wound healing

My 8 year old mix underwent surgery two weeks ago to remove a mast cell tumor on her leg.  The wound was sutured and stapled, but because a large chunk of skin was removed, a lot of stress was put on the incision, the staples and many stitches popped out leaving an area of exposed muscle about 3 x 3 inches.  It is raw, bloody and gross looking.

The vet says there is not enough skin left to close the wound again and claims that the area will eventually granulate, fill in and close up but the wound looks so daunting I'm doubting it will ever happen.  I'm bringing her back every other day right now for bandage changes so the vet is seeing the wound pretty often.  She's on a couple antibiotics and pain meds.

Does anyone have any experience with this?  Can a dog with a large, deep open wound heal up?  I'm unconcerned about any scars, I just want the thing to close up.  Are their any treatments you know of that can help the wound heal faster?  How long does it take for a wound like this to close?  Thanks.
Type of Animal
:  
Dog
Age of Animal
:  
8
Sex of Animal
:  
Female
Breed of Animal
:  
Unknown mix
Last date your pet was examined by a vet?
:  
August 26, 2009
City
:  
Chicago
State/Province
:  
IL
Blood Test Results
:  
Fine.
Other pertinent test results
:  
Mast cell tumor, grade 1, good margins, well-differentiated.
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942207_tn?1283485355
Sorry to hear about your dog.  It is always difficult dealing with cancer in our loved ones -- human or animal.  

Healing by second intention (or healing without the benefit of surgical closure) is a well documented method of wound treatment. Unfortunately, mast cell tumors are notorious for not healing uneventfully.

If your veterinarian is seeing your dog for bandage care every other day then he is doing a great job of staying on top of it. When the wound fills with granulation tissue a skin graft could be considered, but would need to be approached carefully due to the possible presence of mast cells.

I know this type of wound looks awful, but it should heal just fine -- despite the appearance at the moment.

Thanks for visiting MedHelp.  If we can answer any other questions for you, don't hesitate to post them here.
3 Comments
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Avatar_dr_m_tn
Hi Bildo,

The fact that the mast cell was on the leg is a bad point, since as you know by now, there isn't a lot of extra skin to work with.  You may ultimately consider a referral to a board-certified surgeon, for a skin graft as Dr Dew suggested, or possibly a skin flap depending on the exact location.  And there may be other options to close the defect.

But  the fact that your vet obtained clean margins is a good point.  In addition to bandage changes, I would suggest hydrotherapy, which is a fancy word for flushing or rincing the wound with fluids under pressure.

There are many new products on the market now to help with healing.  Again, a surgeon may be a good option to get some input.

Good luck. Don't give up!!!

Please keep us posted.

Phil Zeltzman, DVM, DACVS
Pet surgeon and author of a free, weekly newsletter for true pet lovers, available at DrPhilZeltzman.com
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Avatar_m_tn
Thank you for your replies, Doctors.

We saw the vet again this morning for another bandage change.  The vets seem to think she's healing as she should be, but all I see is a huge open wound.

Fortunately, the area has nice healthy granulation and we're on the painfully slow process of epitheliazation.  Part of her wound is in a high motion area and the skin still appears to be loose from the underlying tissues.  The other side of the wound has already started to regrow "skin" from the outside edge of the wound toward the middle, which is very encouraging.

I asked the vets about the possibility of a skin graft and was told that Margaret has very thin skin and they fear the host site would end up with an open wound when they try to lift a graft.  I asked if there was a canine version of something like Dermagraft for people, but they didn't know of any.  

Also, until today the bandages were changed using Hydrogel, but today it was wrapped using just a nonstick pad.  The reason for the change was that not using Hydrogel allowed for longer time in between bandage changes - 3 days instead of 2.

Do either of you recommend any sort of bandage dressing?  Are there any natural supplements I can give her to stimulate epitheliazation?  

Thanks again for your time.
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