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Lumpectomies: Basics and Beyond

What is a lumpectomy?

Lumpectomy is informal terminology for the removal of a dermal or subdermal mass. A lumpectomy is a very common procedure performed in small animal practice.

Situational Awareness

Unfortunately, veterinary students receive little formal instruction on lumpectomies when one considers how common this procedure is in small animal practice. In most cases, ‘winging it’ by applying a few basic surgical principles and some common sense will suffice to achieve a successful outcome. But why not increase your level of confidence by having the appropriate information? Also, concerns like: Will the site close? Will it stay closed? Can also be alleviated by having a solid understanding of how to manage it.

$250

Get ready to perform a Lumpectomy:

All the information you need. Fully narrated surgical videos. In depth guide and more.

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Pre-Surgical Considerations

  • Reduce tension on skin edges:

    • Identify tension patterns
    • Understand how to properly undermine
    • Undermine sufficiently

    Reduce wound dehiscence:

    •  Reducing tension on the skin edges
    •  Preserving vasculature
    •  Proper use of instruments/gentle tissue handling

    Have a plan for closing after larger masse removal:

    • Be prepared (pre and intra op) to undermine more aggressively
    • Be prepared to do a single pedicle advancement flap
    • Be prepared to use a drain
    • Be prepared to manage as open wound (prepare client)
What the client needs to know:
  • The incision will take approximately 10-14 days to heal
  • Activity should be minimal until incision has healed to prevent undue tension or fluid build up.
  •  Proper care of drain is readily managed by pet owners.

Step by Step Undermining

  • Figure 1
Undermining is easily and commonly done using fine scissors such as Metzenbaums. The undermining should be deep to cutaneous trunci or fascial planes. Blood vessels should be preserved if possible.
  • Figure 2
Skin can also be bluntly undermined using the fingers to gently push through the loose connective tissues located deep to the superficial fascial plane or cutaneous trunci muscle.
  • Figure 3
It is important to undermine sufficiently to remove tension at the skin edges

Get ready to perform a Lumpectomy:

Preferred instrumentation:
  • General instrument pack.
  • Extra towel clamps to help manipulate and approximate skin.
  • Jackson-Pratt drain and grenade over the Penrose drain.
Post-op expectations:
  • Restricted activity for 10-14 days to allow skin to heal.
  • Potential Elizabethan collar or bandage to protect the site from being damaged by the patient.
  • Recheck and remove sutures in 10-14 days
  • Drain covering and management if necessary.
  • Client education on drain management.
What you get when you register:
  • Detailed, narrated information on
  • Basic principles of excising benign dermal and subdermal masses
  • How to successfully manage more aggressive dermal and subdermal masses
  • Burying a subcutaneous knot: why and how
  • How to properly undermine so that the larger lumps are not a problem
  • Single pedicle advancement flaps
  • Free skin grafts
  • Placing drains
  • Reconstructive techniques to avoid
  • Areas that are more difficult and how to manage (if you can’t avoid)
  • Back up plans if a primary closure is elusive.

Q & A

How long will it take for my dog to heal from a lumpectomy?

  • Most lumpectomy site will heal in 10-14 days.
  • Larger lumps that require more reconstruction techniques usually also take about 14 days barring any complications such as fluid accumulating under the skin.

Will the pet require a bandage after a lumpectomy? if so for how long?

  • Most lumpectomies do not require bandages. However a veterinarian may opt to place a bandage to help protect the incision from being licked or to try and minimize motion and/0r fluid accumulation at the site surgical site

Workshop Content