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A mesh graft is a type of skin graft that is used in reconstructive surgery. It is often selected to repair wounds located on a dog's legs. It is preferred in these situations due to its flexibility. Applying a mesh graft to a wound speeds up the healing time drastically while lowering the chance of infection. When a wound is very large, or when the remaining skin is too damaged to regenerate, reconstruction is generally the only option.
The skin that is used for a mesh graft is harvested from elsewhere on the body. The section can be partial or full-thickness. After it is secured onto the wound, it heals onto the new location and resumes growth as regular skin. The blood vessels from the wound site attach to the new skin. This surgery is usually planned after an emergency injury has resulted in a large dermal wound. It should be performed by an ACVS board-certified veterinary surgeon.
When a dermal wound is present, the veterinarian will examine it to determine if a skin graft is necessary. If reconstructive surgery is deemed appropriate, blood work will be run on the dog to assess its overall health status. This can help the vet decide if the dog is a good surgical candidate or not. An area containing excess skin (often on the neck or abdomen) can then be located for the graft harvest site.
Leading to the surgery, the dog will be required to fast for several hours preceding the operation. To begin the procedure, the dog will be given a sedative. An IV will be placed and general anesthesia will be administered. The graft harvest area can then be clipped and disinfected. A sample of tissue will be taken from the wound area to be sent for examination. This can help identify bacterial infections in the skin. All damaged tissue will have to be removed before the graft can be applied. Moist gauze will then be placed over the wound.
A very sharp scalpel will be used to cut out the skin for the graft. Before it is placed on the dog, it will need to be stretched out on a piece of board so that all of the tissue under the layer of skin can be removed. Multiple slits then can be made to the skin giving it a mesh-like appearance. These slits will allow the graft to stretch over the wound and drain fluids while healing. The graft can then be placed over the wound and securely sutured. Tack sutures can be used throughout the surface of the graft to keep it stable on the tissue. Care must be given to ensure that the hair on the graft is going the same direction as the hair on the surrounding skin. Special bandages will then be placed over the graft.
When performed correctly, skin grafts have an extremely high success rate with over 90% of grafts healing onto their new site. Dogs who are suffering from an infection may experience more difficulty healing than those who are not. Your veterinarian may wait up to 10 days after the wound has occurred for the tissue to begin to regenerate to increase the likeliness of success. A small number of mesh grafts only partially take. Others heal properly but do not ever grow hair. If the wound is located on the dog's abdomen, an axial pattern flap may be used instead of a mesh graft.
The dog should be closely monitored when waking from anesthesia. Bandages will be placed over the graft in layers to assist the healing process and keep the area clean. The first layer will have antibiotic ointment on it to stave off harmful bacteria. The second layer will be made of a very absorbent material to draw all drained fluid away from the wound. To keep these bandages secure, a splint may be needed, especially if the graft is on or near a joint.
A balance must be found between keeping the bandages as dry as possible while not interfering with the graft’s healing. In general, bandages will need to be changed every day or two in the beginning, tapering down to once every three to five days. After one week, an appointment will be needed to assess how much of the graft has survived. If a splint was placed, it can be removed after ten days and sutures can be taken out two weeks post-surgery.
A mesh graft generally costs between $500 and $1,000, but can be significantly more if a substantial amount of damage exists. If a biopsy is needed, this adds up to $200 to the overall price. Blood work alone may cost $100. In addition to these costs, anesthesia, medication, and lab work will also be required. There are newer methods to treat large dermal wounds such as shock wave therapy, stem cell therapy, and platelet rich plasma, but these are not offered at many locations and may cost more due to the technology and training needed to administer them.
It is possible for clear fluid or clotted blood to build up underneath the mesh graft. This may prevent the graft from attaching to blood vessels properly. Infection can also develop at the surgery site, complicating the healing process. If the dog is allowed too much movement in the first weeks after the operation has been performed, the graft may break off from the wound. That being said, these complications rarely occur, and a mesh graft is seen as a low risk solution to a large dermal wound. As with any surgery that uses general anesthesia, certain serious reactions can develop after sedation. The dog may have abnormal hair growth at the graft site, but this is only a cosmetic concern and will not cause any discomfort to the animal.
Most skin grafts are needed after a dog has suffered from a severe injury. To decrease the chance of your dog becoming burned, keep it leashed at all times around campfires and other heat sources. Take all measures to keep your home safe from fires, including installing and maintaining smoke detectors in multiple rooms of your home. This will help keep both pets and humans in the house safer.
Leashing your dog on walks can greatly reduce the likelihood that it will get hit by a vehicle. Securing your dog's outdoor area can also decrease the chance of blunt force trauma. If your dog has an open wound, clean it regularly and allow your veterinarian to examine it to assess if stitches or antibiotics are needed. A wound should never be allowed to fester, as this can lead to severe infection.
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