The Challenge: Managing Elbow Wounds in Dogs

Closing skin wounds overlying the olecranon can be difficult in dogs because of the lack of excess skin, susceptibility to repeated impact, compression, and tissue tension. In debilitated dogs that sleep on their sides, wounds are more prone to bacterial infection and abscessation, dehiscence, and incomplete wound healing. Closure techniques for wounds over the elbow area include healing by second intention, simple appositional wound closure, local skin flaps, axial pattern flaps, myocutaneous flaps, distant direct flaps, and skin grafts.

This report highlights the treatment of wounds in the olecranon area in 5 dogs, including elbow ulcerations in 2 dogs, dehiscence after removal of a large infected calcinosis circumscripta lesion, necrotic abscess, and traumatic ulcer formed secondary to focal necrosis in a surgical flap. The surgical approach to the open wounds began with either bipedicle advancement flaps or direct suture apposition of the opposing sides of the wound. Foam pipe insulation was used to provide cushion and protection from repeated trauma and tension to the healing wound for 4 to 13 weeks postoperatively. The pipe insulation also allowed mobility of the affected forelimb. This prolonged protection allowed collagen remodeling and improved circulation to the overlying cutaneous coverage. If immediate postoperative tension is anticipated, the authors recommend short-term immobilization of the elbow joint, followed by application of the foam pipe insulation for long-term support as healing progresses.

CommentaryElbow wounds are challenging to manage, especially in large-breed dogs. This case series describes the use of foam pipe insulation to protect the closure of olecranon wounds. The technique is a useful adjunct to surgical management of difficult-to-treat elbow wounds or hygroma complications. The author’s wealth of experience in reconstructive surgery was evident. In addition, the low cost of foam pipe insulation is a viable alternative to otherwise difficult bandaging techniques.—Jonathan Miller, DVM, MS, DACVS

SourceUse of commercially available foam pipe insulation as a protective device for wounds over the elbow joint area in five dogs. Pavletic MM. JAVMA 239:1225-1231, 2011.