Management of volumetric muscle loss in a dog using bioactive glass–alginate–cellulose composite and a transpositional flap: a case report

This case report describes the management of a complex volumetric muscle loss (VML) injury in a 3-year-old mixed-breed dog following severe trauma to the right forelimb, which resulted in extensive multi-muscle defects that were unsuitable for primary closure. After initial stabilization and surgical debridement, reconstruction was achieved using a transpositional flap, while a gold nanoparticles–bioactive glass–alginate–cellulose (BGAuSP-Alg-MCC) composite was implanted to fill the dead space and support tissue regeneration. Postoperative healing was evaluated through clinical follow-up, computed tomography performed immediately and at 1 and 3 months postoperatively, as well as histological and immunohistochemical analyses. Imaging demonstrated progressive integration of the biomaterial, restoration of tissue density comparable to adjacent muscle, and absence of major complications. Histological evaluation demonstrated moderate inflammation and granulation tissue formation, containing numerous blood capillaries (neoangiogenesis), confirmed by CD31 and α-Smooth muscle actin (SMA) immunolabelling. Functional recovery was favorable, with preserved limb mobility and normal gait. These findings provide preliminary evidence of local biocompatibility and support the feasibility of incorporating the BGAuSP-Alg-MCC composite into a multimodal surgical management approach for extensive volumetric muscle loss in canine patients.