fusion podoplasty

Re: fusion podoplasty

Richard Carter — Wed, 11 Feb 2015 16:01:48 GMT

First one I did, did both paws, fairly radical skin excision, did v.v.well, completely healed at r/s 10 days, no lameness. Next one I did I tried to save some skin, the wounds broke down and now another practice has another client so basically have to be sure the client is aware this is a salvage procedure where the skin has already beyond repair. If it was an ear you would be doing a TECA and a lip fold / nasal fold you would be making big cuts.

Good luck

Re: fusion podoplasty

Tim Charlesworth — Wed, 11 Feb 2015 15:09:00 GMT

I know that this may be an obvious point but if you have sufficient skin left after your web resection you can simply close them over the lateral aspects of the digits and not do a full blown fusion podoplasty. Would be much less bandage intensive during the postop period but you do need enough skin...

Good luck, I never enjoy these!

Tim

Re: fusion podoplasty

emster5 — Tue, 10 Feb 2015 19:09:09 GMT

Thanks Andrew. I will message you for the photos uf you don't mind as I think the client needs to know exactly what is involved. I'm fairly happy with the procedure but I do want them to be aware of the potential complications and how lengthy the tecovery period will be even if all goes well. Cheers, Emma

Re: fusion podoplasty

Andrew Henfrey — Mon, 09 Feb 2015 19:43:00 GMT

Hi Emma

I've done fusions on 8 dogs now, 12 paws, over 9 years. Chronic cysts were the main reason but one dog had walked extensively over fibreglass insulation, and another had congenitally short D5s with conjoined central pads taking all the pressure. The standard expected breeds- 3x Bulldogs, 2x English Bull Terriers, 1 SBT, 1 Boxer and a Cocker Spaniel. All front paws except one.

I would definitely only do one paw at a time. The surgery needs to use of some sort of electrosurgery or CO2 laser. I have the laser as it also allows ablation of cysts, which is a good option in less affected paws. Bargain on about 2-3 hours surgery, use a tourniquet and release the pressure regularly. This surgery definitely needs good analgesia and I have them on MLK infusions. The most important thing with dressings is that the paws should not get any extensor pressure on the toes- so a green splint incorporated in the dressing is critical and extending beyond the toes. I have found using Flamazine within the dressings is very useful. Redress every 2-3 days initially and do sedate for the first few. You may be able to do conscious later. Dressings generally are required for about 6 weeks. I remove the green splint element once the toes seem fused, even if there is still granulation to heal i.e stage-down the support. The one hind paw I have done suggested to me that these are much more difficult to get to heal as preventing toe extension is critical but very difficult.

I hope this helps. If you want any photos to show the client I can dig some out if you would like to PM me.

Good luck!