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What is Reconstructive Surgery?

Reconstructive surgery in cats is used to treat large wounds where a loss of skin has occurred. Large wounds that require reconstructive surgery intervention to allow them to close over and heal successfully may occur from burns, accidents, or tumor removal. Not dissimilar to plastic surgery or reconstructive surgery for humans and other animals, reconstructive surgery in cats involves the use of special suturing and stitching techniques, skin grafts and skin flaps along with surgical mesh. 

Skin has naturally elastic properties and can be stretched to cover larger areas. In addition to this property, reconstructive surgery is effective due to the skin's naturally regenerative qualities. Skin can be used to close only part of a wound, the body will then grow enough skin to close the remaining gap. Surgical techniques that capitalize on this elasticity and regenerative ability are skin grafts, which involve removing skin tissue from one part of the animal's body and transplanting it to another where skin loss has occurred, or the use of flaps of skin that can be detached from tissue adjacent to a wound, rotated and used to cover open wound area. A veterinary surgeon with experience in reconstructive surgical techniques is required to perform reconstructive surgery for your cat.

Reconstructive Surgery Procedure in Cats

Prior to reconstructive surgery your veterinarian may perform routine tests to determine your cat's overall health and likely success of reconstructive surgery or risk from anesthesia. Occasionally, treatment of the wound prior to surgery will be necessary to optimize the chance of successful reconstruction by ensuring tissue is as healthy as possible. Treatment may involve medication or bandaging to optimize the condition of the wound prior to the procedure. The wound must be clean, free of infection, and granulation of tissue present in order for reconstructive surgery to have the best outcome. The night prior to surgery your cat will need to fast to reduce the risk of aspiration during surgery. When your cat arrives at the veterinarian on the day of surgery, they will be examined to ensure that bacterial infection is not present. Your cat will be given a sedative, intravenous anesthesia, and then have a breathing tube inserted to maintain anesthesia by gas. The wound will be cleaned and hair, dirt and other contaminants removed from the surgical area. If emergency trauma had occurred, supportive treatment such as intravenous fluids may be necessary. 

Reconstructive Surgical techniques that may be performed on your cat include:

Suturing and Other Surgical Techniques

Specialized sutures, such as tension relieving sutures, may be placed at the wound site. Tension relieving sutures are a pattern of sutures that hold skin edges together where there is a lot of tension, or a tight closure over the wound. These sutures relieve the stress on the skin and allow for better circulation and healing.

Wounds on joints may be aggravated by constant motion; a veterinary surgeon may make an incision on the opposite side of the joint to release tension and allow the skin on the opposite side to close over the wound located at a joint. The incision made will heal on its own.

Skin Flaps

Because skin can be manipulated and stretched, skin that is located next to the open wound can be lifted from its natural bed and manipulated, rotated and stretched to cover the open wounds. In order for this to work, loose skin adjacent to the wound needs to be available. If this is not the case, skin adjacent to the wound can be stretched prior to surgery by using expanding devices under the skin, or bands on the surface of the skin.

Skin Grafts

When adjacent skin is not available, skin can be removed from one part of the body and transported to the open wound site where it can be sutured in place. Sometimes surgical mesh may be used to facilitate this by providing a binding site and structure for the grafted skin to bind to.

Reconstruction may require more than one surgical procedure to achieve the desired results.

If reconstructive surgery is being conducted at the same time as tumor removal, your veterinarian will change gloves and instruments between surgeries to minimize the risk of contamination by neoplastic (abnormal cell) tissues.

Hospitalization and cage rest may be recommended for a short time to ensure that healing begins before your cat is sent home for recovery. Pain medication and antibiotics will be administered as required.

Efficacy of Reconstructive Surgery in Cats

Due to the skin's naturally elastic and regenerative capabilities, reconstructive surgery is very successful at addressing healing in wounds where loss of original tissue is an issue. Advances in reconstructive surgical techniques have increased the effectiveness of this form of surgical intervention to aid cats and other animals in achieving complete healing and restoration of function where traumatic injury or disease have resulted in large wounds.

Reconstructive Surgery Recovery in Cats

Post-surgery, your cat may be administered medication such as painkillers or antibiotics as deemed necessary by your veterinarian. If necessary, cage rest may be recommended immediately after surgery until healing has begun. Reconstructive surgery in your cat involving skin grafts or flaps are usually bandaged to allow granulation of tissue in the wound to develop and encompass the skin graft. This bandaging must be monitored to ensure that circulation is not cut off or movement impaired. Any reconstructive surgical site will need to be protected from licking or chewing by your cat or other pets in the home. An Elizabethan collar may be recommended by your veterinarian to prevent your cat from interfering with the wound and any other pets should be restricted from access to your cat. The reconstructive surgical area should be kept clean and checked routinely for signs of infection and to ensure healing. Your cat’s mobility should be restricted; eliminate outdoor activity and strenuous exercise until healing has occurred, this includes preventing your cat from jumping up on high perches or playing strenuously with other pets. 

Follow-up will be scheduled by your veterinarian. Follow your veterinarian's instructions on wound management, bandaging, and postoperative medications. 

Cost of Reconstructive Surgery in Cats

The cost of reconstructive surgery for your cat is a specialized field requiring specialized training for your veterinarian. Costs for this procedure, including anesthesia, can range from $1,000 - $2,000 depending on the extent of reconstruction and techniques employed. The cost of living in your area is also a factor. 

Cat Reconstructive Surgery Considerations

Underlying conditions or disease may interfere with healing and the success of reconstructive surgery and should be considered before proceeding with this surgery. Surgery recommended to heal wounds where tumors have been removed should first take into account any metastasis of tumors (spreading of cancer) and the pet’s likelihood of a meaningful recovery. In addition, disease such as Cushing's disease or feline diabetes, feline leukemia virus or any other immune system dysfunction may inhibit healing and affect the successful outcome of reconstructive surgery. Cats with these conditions may not be good candidates for this procedure. 

Reconstructive Surgery Prevention in Cats

Preventing trauma such as car accidents or fights with other animals can be achieved by keeping your cat indoors or on a leash when outside. This will eliminate traumas that may require reconstructive surgeries. Monitoring your cat's health and being aware of any growths or tumors when they are at an early stage to receive treatment will result in a wound that may be more manageable and less likely to require reconstructive surgery due to size. Treatment of fungal and bacterial conditions at an early stage will reduce the likelihood of having a wound that becomes chronic and does not close over on its own.