Use of self-inflating tissue expanders in equine surgery: A prospective study of 20 cases

Abstract

Background: Tissue expansion is a well-established technique in reconstructive surgery. Self-inflating tissue expanders (STE) have not been widely adopted by veterinary surgeons, and clinical descriptions of their use in horses are lacking. Objective: To describe the indications, clinical experiences and outcomes of a series of equine cases that used a hydrogel-based STE to assist soft tissue reconstruction. Study design: Prospective clinical study. Methods: Case details, surgical techniques and outcomes were recorded for horses requiring use of an STE, using a predesigned data collection sheet completed by the treating surgeon. All horses underwent two surgical procedures as part of their treatment: one to place the STE(s) and a second to remove the device(s) and perform reconstructive surgery using the expanded tissue. Results: Twenty horses had STEs implanted at seven clinics and had sufficient follow-up for inclusion in the study. Indications for using the expanders included the following: expansion of skin prior to excision of a neoplastic lesion (n = 13), repair of a sinocutaneous fistula (n = 2), repair of chronic scarring or a nonhealing wound (n = 2), repair of a full-thickness ear pinna defect (n = 1) and repair of a rectovestibular injury (n = 2). The degree of tissue expansion was graded as good in 19/20 cases (95%) and provided sufficient tissue to cover the entire defect in 11/20 cases (55%). STE-associated complications occurred in 9/20 horses (45%), but none of these complications were serious. The final clinical outcome was graded by the treating surgeon as good or excellent in 15/20 horses (75%). Main limitations: Only one type of STE device is described, and its use was not compared with other treatments. Information regarding use of the STE at locations other than the head (n = 3) is limited. Conclusions: Use of a STE device in horses resulted in no serious complications and provided a good outcome in a variety of equine clinical cases.