Degloving injury in a 7-year-old mixed-breed dog

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A previously healthy 7-year-old castrated male mixed-breed dog was referred to the Cornell University Hospital for Animals (CUHA) Emergency Service for further evaluation of severe trauma secondary to being hit by a vehicle. Immediately after the dog was injured by the vehicle, he was presented to a emergency veterinary clinic and administered intravenous (IV) fluid therapy, pain medication, antibiotics, and analgesics. Referral physical exam revealed extensive degloving wounds to both forelimbs, and crepitus in the right brachial region. Extremity radiographs were obtained and revealed a fracture of the right humerus. The forelimb wounds were lavaged and bandaged, and he was referred for specialist care due to the extent of his wounds. On initial evaluation at CUHA, the dog was unstable with tachycardia, tachypnea, pale mucous membranes, mildly decreased peripheral pulse quality, and a mildly prolonged capillary refill time. He was stabilized treated with IV fluid therapy and full-mu opioid pain medication. Physical exam revealed left brachial instability and crepitus, consistent with a humeral fracture, and a dorsally luxated right maxillary canine tooth. Following stabilization, he was administered broad-spectrum antibiotics. Point-of-care bloodwork showed anemia, hypoproteinemia, and electrolyte derangements (characterized by hyponatremia and hypokalemia). Focused abdominal and thoracic ultrasound were unremarkable. The dog was sedated and evaluation of his wounds revealed degloving wound involving approximately 40% of the circumference of the antebrachium of both forelimbs, with full-thickness soft-tissue loss on the dorsal aspect of the left forelimb and exposure of the carpal bones and metacarpus. This talk will discuss emergency stabilization of the trauma patient and approaches to wound management.

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Degloving injury, emergency stabilization, orthopedic surgery


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case study

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