Advance skin edges to the center of the defect with walking sutures and subcuticular sutures. Appose skin edges with appositional sutures.
- Multiple mammary masses on the same dog may be of different histologic type. Submit all for histopathology.
- Dogs usually have five pairs of mammary glands and could have four pairs.
- With the exclusion of inflammatory carcinomas, surgical excision is the gold standard treatment for mammary masses.
MOST COMMON COMPLICATIONS AND DIFFICULTY
- Excessive tension at closure with resulting dehiscence.
- Be sure to eliminate deadspace to avoid seroma formation, particularly in the inguinal area.
- "Watching" a mammary mass. ALL mammary masses should be excised, even if cytology suggests a benign growth. Aspirates can miss malignant cells in mixed tumors and malignant transformation is believed to be possible with benign mammary masses.
- Careful apposition of subcutaneous tissues minimizes tension on skin sutures. If a large subcutaneous cavity remains in the inguinal region, consider placing a closed suction drain.
- Consider staging procedures and doing unilateral, rather than bilateral, mastectomies. Bilateral mastectomies are NOT recommended.
Always attempt to get wide margins around the mass and always submit it for biopsy! There is usually very high tension on the wound so using a suture with good long term tensile strength may be advised.
SUTURE AND NEEDLE OPTIONS
|Brand||Needle Type||Needle Reference|
|Main Choice||Also Possible||Main Choice||Also Possible|
|MUSCLE (if any)||PDS* II
|VICRYL*||Taper Point||SH, CT-2, CT-1|
|Taper Point||RB-1, SH, CT-2, CT-1|
|Silk||Reverse Cut||FS-2, FS-1, FS||FSL, CP-2, CP-1, KS|
(20 lbs or less)
(20-45 lbs or less)
(50 to 75 lbs)
(75 lbs +)
|MUSCLE (if any)||4-0 or 3-0||3-0 or 2-0||3-0 or 2-0||2-0|
|SUBCUTANEOUS||4-0||4-0 or 3-0||3-0 or 2-0||2-0|
|SKIN CLOSURE||4-0||4-0 or 3-0 or 2-0||3-0 or 2-0||2-0|