Indications, complications, and outcomes associated with subdermal plexus skin flap procedures in dogs and cats: 92 cases (2000–2017)

Abstract

S ubdermal plexus skin flaps, also known as local or random pattern flaps, may be used to reconstruct skin defects in dogs and cats when primary closure is not possible. Relatively simple to perform, an SPSF procedure may be preferred when a choice exists between that and a more advanced reconstructive technique, such as axial pattern flap or free-skin graft procedures. Unlike axial pattern flaps, SPSFs do not contain a specific or named direct cutaneous artery and instead derive their blood supply from the terminal branches of cutaneous trunci vessels in the subdermal plexus, which run from the base of the flap. However, in some anatomic areas, the wider the base of the SPSF, the greater the chance of accidentally incorporating part of an adjacent direct cutaneous artery. 1,2 Subdermal plexus skin flaps can be classified according to their location relative to the skin deficit Indications, complications, and outcomes associated with subdermal plexus skin flap procedures in dogs and cats: 92 cases (2000-2017

Locoregional Flap Reconstruction Following Oromaxillofacial Oncologic Surgery in Dogs and Cats: A Review and Decisional Algorithm

“…Efficient pain management relies on a multimodal approach combining strong opioids, non-opioid analgesics, and peripheral or neuraxial local anaesthetics acting on different sites of the pain pathway (82,89). In our institution, and in agreement with others, perioperative analgesia is achieved through a combination of locoregional anaesthesia using ropivacaine and constant rate infusion of drugs (opioids, lidocaine, ketamine, or dexmedetomidine) for the first 24-48 h (6, 62,78). Other drugs that may be used include non-steroidal anti-inflammatory drugs and gabapentinoids.…”

“…In a recent retrospective study, the complication rate for random flaps in the face and head area was 17%, with no major complications (>50% flap failure or requiring a second surgery) reported. This was significantly less than for skin deficits of the torso or limbs (78). The most common complication was dehiscence of the distal wound edge.…”

“…Advancement and transposition flaps had lower complication rates than rotation flaps. The mean time (±SD) to onset of clinical signs of complications was 6.9 days (±4.0) (78).…”

“…Great heterogeneity amongst studies is also found in the veterinary literature. In a recent retrospective study on subdermal skin flaps in dogs and cats, an active drainage was placed in 11% of the cases and a passive one in 26% of the cases according to the surgeon preference (78). In a retrospective study on axial pattern flap in dogs and cats, wound drains were used in 66% of the dogs and 38% of the cats and removed after a median of 2 days in dogs and 3 days in cats (81).…”

Angularis oris axial pattern flap as a reliable and versatile option for rostral facial reconstruction in cats

“…1,6 Subdermal plexus flaps can reconstruct most defects of the head; however, limitations of size, partial necrosis, and suture dehiscence are reported, especially for rostral wounds. [6][7][8] Axial pattern flaps have a high survival rate and allow transfer of larger segments of skin for longer lengths, which makes them a more favorable option for rostral facial reconstruction. 6,9,10 Common axial pattern flaps reported for the head are the caudal auricular, superficial temporal, and omocervical cutaneous flap.…”