|Fig. 1a: Excessive skin fold in perivulvular area of a spayed mixed breed dog.|
|Fig. 1b: Same dog as Fig. 1a; the chronically inflamed vulva is exposed by|
pushing the skin fold dorsally.
Medical treatment consisting of hair clipping, medicated soaps and shampoos, and topical and systemic antibiotics may improve the condition, but surgical resection of the excessive skin is necessary to achieve successful long-term resolution.(1) Episioplasty is a skin reconstructive surgical procedure to correct excessive perivulvular skin folds and is well described in standard surgical textbooks.(Fig.2)
Episioplasty has been used for many years to treat perivululvar dermatitis in dogs that did not respond to more conservative treatment but has also been shown to be an effective treatment for the chronic urinary tract infection associated with perivulvular dermatitis.(2) In this blog we will describe the surgical technique and postoperative care for episioplasty in dogs.
After placing the dog under general anesthesia, it is positioned in ventral recumbency and the perivulvular region clipped and prepared for aseptic surgery. Administer prophylactic intravenous antibiotics, such as cefazolin, to establish blood levels prior to the surgical procedure. Empty the anal sacs and place a purse string suture in the anus to prevent fecal contamination during the perioperative period. Pull the tail dorsally and cranially and secure with tape.
The redundant perivulvular skin is carefully examined to determine how much will require resection. The proposed area of skin to be removed is marked to aid in excision.(Fig.3)
|Fig. 3: The proposed area of perivulvular skin to be resected is marked with a sterile marking pen.|
|Fig 4: Appearance of the surgical site after resection of the perivulvular skin fold..|
|Fig. 5: Appearance of the surgical site after completion of the skin closeure.|
Postoperative care consists of analgesic therapy such as tramadol and a NSAID (if not contraindicated), ice packs on the incision for the first 24 hours followed by warm compresses, and exercise restriction until the incision is healed and skin sutures removed.(Fig.6)
|Fig 6: Appearance of the surgical site 3 weeks postoperatively.|
Complete resolution of the skin fold pyoderma should occur after resection of the excessive skin. Episioplasty is effective in treating perivulvar dermatitis.and in treating chronic urinary tract infection that is secondary to ascending infection from excessive skin folds around the vulva.(2)
1. Bellah JR. Surgery of intertriginous dermatoses. In: Saunders Manual of Small Animal Practice. 3rd edition, Birchard and Sherding, eds., Elsevier, St. Louis, 2006. Pg. 537.
2. Lightner BA, McLoughlin MA, Chew DJ, Beardsley SM, Matthews HK. Episioplasty for the treatment of perivulvar dermatitis or recurrent urinary tract infections in dogs with excessive perivulvular skin folds: 31 cases (1983-2000). J Am Vet Med Assoc 219: 1577-1581, 2001