More than meets the eye

So here is your classic "I have no idea what happened doc, just noticed it today" case.  Poor little dog came in with this horrific wound on its back.  I would say a day or two old.  Mind you, this is a 6 lb dog that lives outside covered in fleas.  The owner would "like to keep her around awhile, but only if it cost less than $400." Story of my life.  Anyway, I'm just sharing because it's kind of an interesting case with pictures.  Hopefully I will have follow up photos.

Here is the wound as presented.

After clipping

After debriding the edges and some of the dead, dirty tissue

The problem with this wound though, is that there is a ton of damaged tissue still remaining.  Also much of the remaining skin is not attached to the underlying subcutaneous tissue and muscles (think skinned alive but with the skin still on).  This can compromise the blood supply to the skin meaning that even though we closed the wound additional skin could still die and she may need additional surgery-hence the more than meets they eye!  Although what you can see in the pictures alone is pretty impressive.

After the suturing it looks pretty good.  Hopefully it stays that way.  She is being treated with antibiotics, pain meds and laser therapy.  We suspect she was bitten and shook by a larger dog.  There were some additional puncture wounds and it's just too much damage for getting cut on the fence, nail, etc.  In a way she was lucky, but she may still have a long way to go if that luck does not hold up.