The Medial Saphenous Fasciocutaneous Free Flap in Dogs

Abstract

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.

Evaluation of an Axial Pattern Flap Based on the Cranial Cutaneous Branch of the Saphenous Artery: A Cadaveric Perfusion Study

“…Our results concur with previously published descriptions of the branching pattern from the saphenous artery. Degner et al noted two cutaneous branches, the more proximal of which coursed caudally and proximally, with the more distal branch extending cranioproximally . This latter branch was identified by Collins and others as the CCSA and was reliably identified in all dogs of our study.…”

Microvascular Free Tissue Transfer of the Rectus Abdominis Muscle in Dogs

“…Philibert et al, reported seroma formation in four of four dogs following free tissue transfer of the trapezius musculocutaneous flap 15 . Finally, Degner reported seroma formation and partial donor site dehiscence in two of six medial saphenous fasciocutaneous free flaps 19 . In 28 28 comparison to the morbidity associated with tissue harvest from other canine free tissue transfer donor sites, harvesting of the rectus abdominis is associated with minimal morbidity.…”

“…Initially the angiosome of the medial saphenous vasculature was defined through angiography. The medial saphenous fasciocutaneous free flap was then successfully transferred to a forelimb defect in six consecutive research dogs 19 . Medial saphenous fasciocutaneous or myocutaneous free flaps were then successfully transferred in eight clinical cases 20 .…”

Concurrent Use of a Medial Saphenous Fasciocutaneous Free Tissue Flap and External Skeletal Fixation for Treatment of a Distal Antebrachial Injury in a Dog

“…A medial saphenous free fasciocutaneous flap 2 was harvested from the medial surface of the right pelvic limb. Its boundaries extended from the distal third of the femur to the proximal third of the tibia and spanned a width of approximately 6 cm.…”

“…Conventional reconstructive techniques often cannot be used for skin loss on the distal aspect of the limbs. Axial pattern skin flaps have been used for proximal antebrachial wounds 1 but are not applicable for repair of distal antebrachial wounds 2 . Skin grafts are not recommended in wound beds with exposed bone, joint, tendon, or those subject to excessive motion.…”