Blizzard's reconstructive surgery

Blizzard, the 3 year old Samoyed, first visited our clinic in May 2006 after having an unfortunate altercation with a motor vehicle. Luckily for him the only injuries he sustained were some deep cuts on his right hind foot which required stitches. However at the time we noticed that he had quite a lump on the very top of his head. A fine needle aspiration was taken of the lump at the time of the surgery, where we attempted to draw out some cells from the lump to look at under the microscope to get an idea of what it was. Unfortunately all we got was lots of red blood cells, which is not useful in trying to come to a diagnosis.

After making a full recovery from his accident, we again saw blizzard in January 2007, because the lump on the top of his head had suddenly become around 3 times the size it was previously, and Blizzard was bumping it into things and traumatizing it. As it was so large we knew it would be very difficult to remove. There is not much spare skin on the top of a dogs head, so we wanted to know exactly what kind of tumour we were dealing with in case it needed removing with very wide margins, a requirement with some forms of invasive skin cancers.

We first performed an incisional biopsy, were a portion of the lump is removed to send to the laboratory for diagnosis. Blizzards lump was consistent with a tumour called a trichoblastoma, which is a relatively common benign tumour arising from hair follicles, usually presenting as singular tumours on the head and neck of dogs. In spite of their sometimes rapid growth they tend not to metastasise and if removed completely they tend not to recur. This was great news for Blizzard, as it meant that all we needed to do was remove the lump with narrow margins, however given its size this was going to be no easy task, and was going to involve some reconstructive surgery to replace the skin on the top of his head once the lump was removed.

Blizzards surgery went ahead in early February, and Dr McPhee performed what is known as a right caudal auricular pattern flap to cover the defect left by the lump. This basically means that she used a flap of skin from the right side of Blizzards neck (where he had ample to spare) and twisted it around to cover the top of his head and stitched it in place. This can be a tricky procedure as it is very important to make sure the blood supply to the flap of skin we use stays intact so that everything can heal properly.
Blizzard recovered well from the surgery, and after many post operative checks to make sure everything was going well he has now had all his sutures removed and everything is healing very well. Once his hair grows back, we will hardly be able to tell that Blizzard has had such radical surgery!


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