Skin reconstruction in veterinary patients can be one of the most challenging aspects of surgical practice—especially when faced with large open wounds or complex closures following tumour resection. In her comprehensive and RACE-approved webinar, Lynda Rutherford, a soft tissue surgeon from the University of Edinburgh, expertly guides us through the art and science of managing these tricky cases.

Whether you're an experienced surgeon or a general practitioner looking to refine your wound care approach, Lynda’s insights offer practical, clinically relevant knowledge grounded in current best practice.

Whole Patient First: Prioritising Life Over Lesions

Before diving into specific techniques, Lynda reminds us of a fundamental truth: wound management must never occur in isolation. Stabilising the patient, addressing life-threatening injuries, and ensuring proper function of major body systems must always take precedence.

Once stabilised, attention can turn to wound management—starting with thorough lavage, decontamination, and debridement. These steps are crucial for preparing a wound bed capable of supporting healthy granulation tissue, which is the cornerstone of successful closure.

Dressings and First-Line Decisions

Lynda discusses various dressings tailored to the specific phase of wound healing—from absorbent dressings for exudative wounds to non-adherent options for fragile granulating tissue. Particularly useful is her discussion of tie-over dressings, which are ideal for facial and cervical wounds where traditional bandaging is impractical. These dressings not only secure the wound covering but can also help stretch the skin in preparation for closure.

Wound Closure: Technique and Timing

Perhaps one of the most valuable takeaways from the webinar is Lynda’s emphasis on when not to close a wound. She strongly advises against closing wounds with ongoing necrosis or infection—an error that can lead to failure and complications.

For suitable wounds, Lynda covers tension-relieving techniques, such as subdermal sutures and planning using towel clamps. She then explores the use of skin flaps, including:

• Subdermal plexus flaps – versatile and commonly used, though dependent on local blood supply.

• Axial pattern flaps – providing a more robust blood supply, ideal for larger or more demanding reconstructions.

Her technical advice is clear, well-explained, and supported by real-world examples.

Skin Grafts: Precision and Patience

When it comes to skin grafts, Lynda clearly differentiates between grafts and flaps, noting that grafts lack an immediate blood supply and rely entirely on the recipient bed for survival. As such, they are best suited for distal limb wounds, especially where circumferential skin loss is significant.

Her guidance on graft preparation, immobilisation (for a minimum of two weeks), and aftercare is particularly valuable. She highlights that success often hinges on attention to detail, patient nutrition, and avoiding complications such as seroma, haematoma, and infection.

Species-Specific Considerations: Dogs vs Cats

An interesting portion of the webinar delves into the differences in pain management and wound healing between species. Lynda notes that cats often require more cautious pain control and that early feeding is essential in both species to support healing and overall recovery. She also stresses the importance of owner communication—particularly regarding the potential for complications such as dehiscence, oedema, infection, and fat necrosis.

A Webinar Worth Watching

Lynda Rutherford delivers a webinar that is equal parts practical and insightful, providing a clear roadmap for managing large wounds and complicated closures. Her experience in referral practice shines through, yet her teaching is highly accessible for general practitioners.

For any vet dealing with reconstructive surgery, or simply aiming to boost confidence in wound management, this session is an invaluable resource. From initial triage to post-operative care, Lynda covers the entire journey with clarity, skill, and a touch of Scottish humour.

Interested in levelling up your surgical skills?
Catch the full replay of Hard Graft! Tips on Skin Reconstruction Surgery via The Webinar Vet and earn RACE-approved CPD/CE while you’re at it.