A 30-MONTH-OLD, female neutered domestic shorthair cat was presented following unwitnessed trauma with a highly contaminated circumferential avulsion of skin from the right hindlimb. The avulsed skin was debrided under general anaesthesia, leaving a wound extending from the proximal femur to the hock (Fig 1). Dressings were changed daily over the next 14 days under general anaesthesia, using wet-to-dry dressings followed by hydrocellular foam dressings (Allevyn; Smith & Nephew). Enterobacter species were cultured from the wound at presentation, and amoxicillin/ clavulanic acid (Augmentin; GlaxoSmithKline, Synulox; Pfizer), marbofloxacin (Marbocyl; Vétoquinol) and clinda mycin (Dalacin C; Pharmacia, Antirobe; Pharmacia) were administered for a total of 21 days.Fourteen days after admission, the wound was covered with healthy granulation tissue, epithelium was forming at the wound edge, and reconstructive surgery was performed. The margins of the recipient granulation bed were sharply excised, and left-and right-sided peninsular caudal superficial epigastric axial pattern flaps were elevated using Veterinary Record (2009) 164, FIG 1: Wound on the right hindlimb of a domestic shorthair cat following initial debridement. The circumferential skin defect runs from the proximal femur to the hock the technique described by Remedios and others (1989) (Fig 2). The common medial border of the flaps extended along the ventral midline from caudal to the first nipple to level with the fourth nipple. The lateral margins of the flaps ran parallel to the medial borders at an equal distance from the nipples. Both flaps were elevated cranially and were dissected away from the external rectus sheath, elevating the mammary tissue and the caudal superficial epigastric vessels with the skin. A single bridging incision from the caudal margin of the ventral midline incision was made through the inguinal skin to the wound on the caudomedial aspect of the right thigh. The skin flaps were rotated through this bridging incision and spiralled down the limb in a clockwise direction with the right flap starting cranially to the left. (a) (c) (b) (d) FIG 2: Elevation and placement of bilateral caudal superficial epigastric axial pattern flaps. (a) Circumferential skin defect (shaded) and planned incision lines to elevate the peninsular flaps and bridging incision (dashed lines). (b) Left and right flaps elevated before repositioning into the skin defect. (c) Right skin flap in its final position spiralling around the proximal right hindlimb in a clockwise direction to fill approximately 50 per cent of the skin defect. (d) Final position of both skin flaps completely covering the circumferential skin defect, and reconstruction of the flap donor sites by advancement and apposition of the wound edges group.bmj.com on June 25, 2015 -Published by
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