The purpose of this study was to identify the angiosome of the medial saphenous artery and vein and to evaluate the use of this cutaneous angiosome as a free skin flap in the dog. In phase 1 of this study, selective angiography of the medial saphenous artery performed in six canine cadavers showed that the skin covering the entire medial femorotibial area, the distal half of the caudal head of the sartorius muscle, and the gracilis muscle were perfused by the medial saphenous artery. In phase 2, a medial saphenous fasciocutaneous island flap was raised and sutured back to the skin edges of the donor wound in three dogs. One hundred percent survival of all of the flaps occurred. In phase 3, a medial saphenous fasciocutaneous microvascular free flap was transferred to a wound that was created over the dorsal metacarpal (n = 3) or metatarsal region (n = 3). The mean length +/- SD of the medial saphenous vascular pedicle was 80 +/- 13 mm (n = 5); the mean diameter +/- SD of the medial saphenous artery was 2.8 +/- 0.2 mm (n = 5) and the mean diameter +/- SD of the medial saphenous vein was 4.2 +/- 0.2 mm (n = 5). One hundred percent of all flaps survived (n = 6). Selective angiography or the distal cranial tibial artery (metatarsal wounds, n = 3) and the median artery (metacarpal wound, n = 3) was performed 3 weeks after surgery. All of the vascular anastomoses were patent and neovascularization of the wound beds was present. This free flap was found to be acceptable for cosmetic reconstruction of wounds located on the distal extremity.
Skin defects on the distal extremity (n = 7) or face (n = 1) of eight dogs were repaired using a medial saphenous fasciocutaneous or myocutaneous flap. The cause of the wounds were ablative oncological surgery (n = 4), trauma (n = 3), or radiation burn (n = 1). The flap was removed from the medial femorotibial region, and transferred to the wound bed. The vascular supply to the flap was reestablished via microvascular anastomosis of the medial saphenous vessels of the flap to recipient vessels isolated adjacent to the wound. Three flaps incorporated the distal half of the caudal head of the sartorius muscle to form a myocutaneous free flap. All flaps survived completely. The medial saphenous fasciocutaneous and myocutaneous free flaps were found to be reliable and cosmetically acceptable for repair of skin defects in dogs.
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