Dr. Herrington- August’s Featured Case

Case background: “Gracie is a 6yr old F/S Boxer mix who presented for removal of about a 1.5cm dermal mass on the dorsal mid shaft R forelimb. The mass removal was the easy part, but closure was difficult. The mass was directly over the cephalic vein, so I did not want to leave it open. I had to undermine completely around the circumference of the leg and make about 2 dozen mesh incisions, as well subQ anchors just to get the skin apposed. Even so it was tight, so I splinted it and applied a modified Robert Jones bandage. I performed daily wet-dry bandage changes, using Entederm (nystatin-neomycin-triamcinolone) ointment, mainly for the anti-inflammatory properties. The skin just didn’t stretch as much as I was hoping, and the cephalic vein was being compressed, so her foot became edematous and the skin around the incision is showing some focalized necrosis. On April 7th I made 2 releasing incisions under bupivicaine, taking great care to leave the cephalic vein covered. I was able to massage a good amount of the edema out. I replaced the splint & bandage, this time switching to silvadene cream. She is also on carprofen and cephalexin orally BID.” – Dr. Herrington