Flap In Dog Research Articles

Hydrodissection to create conjunctival flaps in dogs with corneal ulcers.

Hydrodissection is a liquid injection technique that is rarely used in animal ophthalmic procedures. The use of this technique in the creation of conjunctival flaps for the treatment of corneal ulcers in dogs can improve the outcome, task, and comfort for patients. This study aimed to evaluate the use of hydrodissection in the creation of conjunctival flaps in dogs with corneal ulcers. This study focused on a surgical procedure for creating conjunctival flaps in the eyes of 17 dogs with deep corneal ulcers. We divided the patients into two groups: Hydrodissection was performed in the first group (G1) and conventional divulsion without hydrodissection in the second group (G2). In G1, the conjunctival flap was created by subconjunctival injection of 1 mL of 0.9% sodium chloride, followed by flap construction. The flap was constructed through conventional divulsion using iris scissors in the G2. The operative time, degree of bleeding, and ease of conjunctival divulsion were evaluated during the procedure. Blepharospasm, hyperemia, edema, and scarring of the conjunctiva were evaluated during the post-operative period. Post-operative complications, notably suture dehiscence, were recorded in each group. Hydrodissection is an easy-to-perform maneuver that optimizes the construction of conjunctival flaps. There were no statistical differences in the parameters used to evaluate the trans- and post-operative period between the groups. The volume of sodium chloride administered in the conjunctiva ranged from 0.5 mL to 1 mL in G1. Dehiscence of the flap sutures was observed in four patients (two in G1 and two in G2), with no significant difference between the groups. Hydrodissection facilitates the construction of conjunctival flaps in dogs with corneal ulcers, affording greater comfort to patients and proving to be an excellent option for ophthalmologists.

Complications and influence of cutaneous closure technique on subdermal plexus flaps in 97 dogs (2006-2022).

To determine the incidence and severity of complications for subdermal plexus flaps in dogs and compare the complications when using sutures or staples for cutaneous closure of subdermal plexus flaps. Retrospective monocentric study. Ninety-seven client-owned dogs. Dogs that underwent wound reconstruction using subdermal plexus flaps were retrospectively identified. Type of flap, cutaneous closure technique, complications and level of complication associated with their use were recorded. Follow-up was considered adequate if it was more than 10 days postoperatively or until a complication occurred. Complications were seen in 52 dogs (53.6%), of which 13/18 (72.2%) of dogs had cutaneous closure with skin staples versus 39/79 (49.3%) with skin sutures. The location of the mass/wound on the head and use of an advancement flap was associated with lower incidence of complications (p < .001; p = .018 respectively). Location of the mass/wound on the proximal pelvic limb was associated with a low level of complications (p = .01) on univariable analysis only. On multivariable analysis, only an increased bodyweight was associated with an increased incidence of complications (p = .029). Increased weight may be associated with an increased risk of complications with subdermal plexus flaps. No risk factor was found to be associated with the severity of complications. Overall incidence of complications for subdermal plexus flaps in dogs in this study was 53.6%. The number of dogs included in the study was not sufficient to assess if the skin closure technique affects the incidence of complications.

Short-term outcome and complications following cutaneous reconstruction using cranial superficial epigastric axial pattern flaps in dogs: six cases (2008-2022).

To investigate short-term outcome and complications following the use of the cranial superficial epigastric axial pattern flap to reconstruct cutaneous defects in dogs. Medical records from dogs undergoing reconstructive surgery between 2008 and 2022 by means of cranial superficial epigastric axial pattern flap were reviewed. Data on signalment, reason for reconstruction, defect size, flap healing, post-operative complications and need for revision surgery were collected. Six dogs were included in the study. Indications for reconstruction included neoplasia (4/6), skin necrosis due to vehicular trauma (1/6) and dog bite (1/6). Postoperative complications occurred in 50% of the patients and included seroma (1/6), bruising (2/6) and necrosis of the distal portion of the flap (2/6), with two dogs developing concurrent complications. One dog required open wound management and additional surgery. Overall outcome was scored excellent in three, good in two, and fair in one dog. Despite the relatively high complication rate, most of the complications were deemed minor and could be managed conservatively. Eventually, all wounds healed completely and only one flap required revision surgery.

Outcome of caudal superficial epigastric axial pattern flaps in dogs and cats: 70 cases (2007-2020).

To describe the outcome and complications associated with the use of caudal superficial epigastric axial pattern flaps in dogs and cats. Multicentre retrospective review and descriptive study of clinical records of dogs and cats having undergone caudal superficial epigastric axial pattern flaps between 2007 and 2020. Data retrieved included signalment, aetiology of surgical defect, tumour type, presence/absence of clean surgical margins, presence/absence of post-operative wound infection, use of peri- and post-operative antibiotics, duration of anaesthesia, duration of surgery, presence and duration of hypothermia, presence and duration of hypotension, presence/absence of post-operative surgical drain and length of caudal superficial epigastric axial pattern flap. The incidence of complications and outcomes were documented. Seventy cases met the inclusion criteria; 51 dogs and 19 cats. In dogs, 67% of cases developed complications (59% minor, 8% major) and 33% had uneventful wound healing. In cats, 53% of cases developed complications, (47% minor, 5% major) and 47% had uneventful wound healing. In dogs, the percentage of cases experiencing dehiscence, necrosis, seroma, oedema and post-operative infection was 31%, 29%, 26%, 26% and 16% respectively. In cats, this was 26%, 16%, 11%, 0% and 5% respectively. A good overall outcome was seen in 77% of dogs and 79% of cats. A poor overall outcome was seen in 4% of dogs and 0% of cats. Caudal superficial epigastric axial pattern flaps are traditionally thought more robust than other flaps, yet complication rates remain high, despite a high overall success rate.

Surgical correction of type 1 anal atresia using in adapted Diamond flap in dog

This case report aims to present a case of anal atresia type 1, with anal stenosis in a German Shepherd dog. The surgical technique used was that of the adapted Diamond flap and resulted in a successful resolution of the case. Anal atresia is uncommon in the veterinary clinic, but the one classified as type 1 is the most frequently observed. In the present case the patient presented resolution of the atresia contition and return to sphincter activity confirming that the use of the geometric flap advancement technique is effective for the surgical treatment of type 1 anal atresia.

Evaluation of platelet-rich plasma gel as an angiogenesis-inducing agent in canineadvancement skin flaps

ABSTRACT: This work aimed to evaluate the effect of platelet-rich plasma (PRP) on advancement skin flaps in dogs regarding improvement of vascularization, with focus on increasing its viable area, since there are reports that it is a potential angiogenesis stimulator. The experimental group was composed of eight adult bitches, in which two advancement skin flaps were made in the ventral abdominal region. No product was applied in the control flap (CF), while PRP was used in the contralateral flap, called treated flap (TF). The areas were clinically evaluated every two days until the 7th postoperative day regarding skin color and presence of necrosis. At 10 days, both flaps were removed and submitted to histological examination and blood vessel morphometry. The vessels counted in each group were statistically analyzed by the F-test at 1% probability. Results showed no significant difference in macroscopic changes in the wound, or CF and TF vascularization, thus suggesting that PRP gel did not improve advancement skin flap angiogenesis in bitches under the experimental conditions in which this research was developed.

Evaluation of the Superior Labial Musculomucosal Flap in Dogs: An Angiographic Study and Case Report.

The aim of this study was to evaluate the angiosome of the superior and inferior labial arteries within the superior and inferior labia and to describe superior and inferior labial musculomucosal axial pattern flaps that can be used for intra-oral wound reconstruction. This study also presents the clinical use of a superior labial musculomucosal flap in a dog. The common carotid arteries of six canine cadavers were injected with barium sulphate. The skin of the face and labial mucosa was removed and radiographed to study the vascular supply of the superior and inferior labia. The angiograms in all dogs demonstrated that the superior and inferior labial arteries were located within the musculomucosal layer of the labia. At the junction of the rostral and caudal half of the upper lip, extensive choke anastomoses joined the angiosome of the infra-orbital artery. The inferior labial artery perfused the caudal half of the lower labium and had extensive choke anastomoses with the middle and rostral mental arteries. The musculomucosal flaps of the superior and inferior labia contain a rich arterial blood supply, which suggests that these flaps may survive in live dogs. The superior labial musculomucosal flap was successfully used to reconstruct a large cleft palate in a single clinical case.

Preparation of Recipient Wound Bed by Ultrasound Therapy for Skin Flaps in Dogs

Preparation of Recipient Wound Bed by Ultrasound Therapy for Skin Flaps in Dogs

Preparation of Recipient Wound Bed by Electrical Stimulation for Skin Flaps in Dogs

Preparation of Recipient Wound Bed by Electrical Stimulation for Skin Flaps in Dogs

The Omental Pedicle Flap in Dogs Revised and Refined: A Cadaver Study

To expand current knowledge on the canine omental vasculature and refine the existing lengthening technique of the canine omentum. Ex vivo study. Canine cadavers (n=20). In 10 canine cadavers the omental arteries were mapped using intravascular latex injection and these results were used to create an omental pedicle flap based on the splenic artery in 10 additional cadavers. The operating range of the flap was recorded with particular attention to the main regions of interest for omental transposition in dogs (axillary and inguinal regions). The superficial and deep omental leaves were each predominantly supplied by a left and a right marginal omental artery that anastomosed near the caudal omental border into a superficial and a deep omental arch, respectively. Anastomoses between arteries of the superficial and the deep omental leaves were weak and inconsistent, except for 1 anastomosis that was found in 8 of 10 dogs. By transposing the intact omentum, the right axilla could be reached in 3 dogs, both axillae in 1 dog, and both groins in all cadavers. In all cases, the omental pedicle reached to and beyond the axillary and inguinal regions. By unfolding the pedicle leaves, the width of the pedicle tip could be doubled. When lengthening the omentum is necessary to reach extra-abdominal structures, the omental pedicle flap based on the splenic artery appears to preserve the omental vascular supply. These observations warrant further clinical trials to evaluate this new omtental flap technique in vivo.

Indications, outcome and complications with axial pattern skin flaps in dogs and cats: 73 cases.

To determine the indications, frequency of complications and long term outcome associated with axial pattern flaps used to repair wound defects in dogs and cats. Medical records from two independent referral centres for dogs and cats undergoing wound repair with an axial pattern flap were reviewed. Seventy-three animals were included, 49 dogs: 24 cats. Indications for axial pattern flaps were chronic wounds (43/73; 59%) and closure following tumour resection (30/73; 41%). Axial pattern flaps used were: thoracodorsal, caudal superficial epigastric, reverse saphenous conduit, superficial brachial, deep circumflex iliac, superficial cervical, caudal auricular, lateral thoracic, cranial superficial epigastric, genicular and superficial temporal. Postoperative complications occurred in 64 patients (89%) and 8 patients (11%) had no complications. Complications were: dehiscence, swelling of the flap, necrosis, infection, discharge and seroma. Flap outcome was excellent in 16 patients (23%), good in 29 (41%), fair in 21 (30%) and poor in 5 (7%). There is a high complication rate associated with axial pattern flaps but these are usually easily managed and long term outcome is excellent, in either species.

Lack of usefulness of ureteral reconstruction with free bladder mucosa flap in dogs confirmed by microangiography.

BackgroundThere is a paucity of data addressing the blood supply in the surgically reconstructed ureter, and complete lack of microangiographic studies of the reconstructed ureter with the use of a free bladder mucosa flap. The present study evaluated the blood supply in the reconstructed dog ureter after a 5-centimeter segment resection, supplemented by a tube constructed from a free bladder mucosa flap.Material/MethodsFemale mongrel dogs (n=29) were used in this study. Under general anaesthesia, a 5-centimeter autologous free bladder mucosa flap was used to construct a tube, which was afterwards grafted to replace a 5-centimeter ureter resection. After a period of 3 months (n=2) and after 1 year (n=2), microangiography was performed to assess the revascularization of the grafted ureter.ResultsIn our study, we observed the continuity of the ureter, but the grafted reconstruction was narrowed by the cicatrization in about 86% (n=25) of cases. This resulted in the development of hydronephrosis, as described in previous publications. The ureteral wall was covered by a normal urothelium, but consisted of fibrous connective tissue, which failed to restore a regular (normal) coat. The reconstructed segment showed no smooth muscle cells. A few smooth monocytes were found only at the border with intact portions of the ureter. The microangiography performed at the end of the experiments showed no vascularization of the restored segment of the ureter.ConclusionsThe experiments showed a whole regeneration of urothelium in the transected and reanastomosed ureters. However, there was no regeneration of the muscular coat and a complete lack of revascularization.

Preservation of Canine Composite Facial Flaps Using UW Solution

To evaluate the effect of University of Wisconsin (UW) solution on composite facial flaps in dogs to offer a preservation time limit for clinical application. The experiment included 2 parts. In part 1, 32 half facial flaps were cold stored for 12, 24, 36, and 48 hours in UW solution (experimental group) or normal saline (control group). In part 2, 8 flaps that had been cold stored in UW solution for 24 (group A, n = 3), 36 (group B, n = 3), and 48(group C, n = 2) hours were autotransplanted. After preservation in part 1, the viability of each tissue type (skin, mucosa, muscle, blood vessel, nerve, and gland) in the experimental groups was better than that in the control group. Muscle viability decreased more quickly than did the viability of other tissue. In the experimental groups, the viability of all tissue preserved for 12 and 24 hours was better than that of tissue preserved for 36 and 48 hours. After 48 hours of preservation, tissue had good structure and integrity in the experimental group but showed degeneration in the control group. In part 2, the flap survival percentages were 100%, 100%, and 99.7% in group A; 93.2%, 95.7%, and 94.1% in group B; and 87.2% and 86.1% in group C. Six months after surgery, the dogs in group A showed contraction potential and corneal reflex. Twenty-four hours could be considered a reference time for clinical application of UW solution flap preservation.

Combination Auriculopalpebral Nerve Block and Local Anesthesia for Placement of a Nictitating Membrane-to-Superotemporal Bulbar Conjunctiva Flap in Dogs

The purpose of this study was to evaluate the efficacy of combined local anesthesia in dogs undergoing nictitating membrane (NM)-to-superotemporal bulbar conjunctiva flap construction. Medical records of 47 dogs that had received local anesthesia for NM-to-superotemporal bulbar conjunctiva flap were reviewed. Combined local anesthetic technique included auriculopalpebral nerve block, topical anesthesia of the eye, and infiltration anesthesia of the superotemporal bulbar conjunctiva and palpebral surface of the NM. Forty-two (89.3%) dogs complied with the anesthetic procedures and underwent NM flap without general anesthesia or sedation. No complications were related to the combined local anesthesia. Combined local anesthesia for NM-to-superotemporal bulbar conjunctiva flap may be a time- and cost-effective method that produces both analgesia of the surgical site and akinesia of the eyelid.

Reconstruction of thoracic esophagus with pediculated diaphragmatic flap in dogs

To verify whether pediculated diaphragmatic flaps were suitable to correct iatrogenic wounds in dog's esophagus injuries. Seven dogs were submitted to resection of a segment of the esophageal wall, which was then corrected by suturing a pediculated diaphragm flap. Endoscopic evaluation of the esophageal wall was done forty days after the surgical procedure. Three animals died, one due to implant ischemia, caused by strangulation of the phrenic artery; other due to wound infection; and the last, due to mediastinitis. Scar retraction was observed, however, there was no stenosis, allowing the passage of a 9,8 mm probe with no difficulty. The limits between the implants and the native esophagus were indistinguishable, and the implant was covered by esophageal mucosa. The diaphragmatic flaps are suitable on the restoring of continuity in dog's thoracic esophagus.

Ultrasonographic and color-flow Doppler ultrasonographic assessment of direct cutaneous arteries used for axial pattern skin flaps in dogs

To describe a method for ultrasonographic and color-flow Doppler ultrasonographic imaging of the 4 direct cutaneous arteries commonly used for axial pattern skin flaps in dogs. Descriptive report. 20 clinically normal dogs. Dogs were manually restrained and fundamental and harmonic ultrasonographic and color-flow Doppler ultrasonographic examinations of the superficial cervical, thoracodorsal, deep circumflex iliac (cranial and caudal branches), and caudal superficial epigastric arteries were performed by a resident in diagnostic imaging. The level of confidence in locating these vessels was subjectively graded as high, moderate, or low. High-frequency fundamental and harmonic ultrasonography was important for maximizing image resolution, and color-flow Doppler ultrasonography was important for vessel identification. The superficial cervical artery was the most difficult vessel to identify; confidence in correct vessel identification was low or moderate. The thoracodorsal and deep circumflex iliac arteries were identified with a moderate or high level of confidence. The caudal superficial epigastric artery was the easiest vessel to identify; confidence in correct vessel identification was high. Except for the superficial cervical artery, the level of confidence in correct vessel identification improved over time as operator experience increased. Results suggest that the combination of fundamental ultrasonographic and color-flow Doppler ultrasonographic imaging is an easy and noninvasive method for identifying the 4 direct cutaneous arteries commonly used for axial pattern skin flaps in dogs. This method could be useful in planning axial pattern skin flaps, particularly in dogs with regional soft tissue trauma in which the integrity of the vessel is in question.

Tolerance of Cutaneous or Mucosal Flaps Placed into a Radiation Therapy Field in Dogs

To determine the clinical outcome and factors affecting cutaneous or mucosal flaps in dogs treated with radiation therapy (RT). Longitudinal clinical study. Twenty-six client-owned dogs. Dogs entered in the study had a flapping procedure and RT as part of their treatment. The sequence of flapping and RT included: (1) planned preoperative RT, (2) postoperative RT, and (3) flapping as a salvage procedure for management of complications or local tumor recurrence after RT. Flap complications were defined as necrosis, local infection, dehiscence, and ulceration. The risk and severity of flap complication were analyzed independently. Twenty (77%) dogs had a complication; 6 dogs required an additional flapping procedure; and 4 dogs had an unresolved complication. Flapping procedures performed to correct a complication, or failure of RT, had a significantly greater risk for complication; however, postoperative RT decreased the severity of complication. A dose per fraction of 4 Gy compared with 3 Gy was prognostic for increased severity of complications, whereas the head and neck location was prognostic for decreased severity of complication. Although morbidity was substantial, cutaneous or mucosal flaps were used successfully in an RT field in 85% of the dogs. Flaps that were part of the planned therapy as opposed to those used to correct a complication or failure of RT had a better clinical outcome. Cutaneous or mucosal flaps can be part of the treatment of dogs with tumor when adjuvant or neoadjuvant RT is to be used.

Use of a rivet-like titanium clamp closure system to replace an external frontal bone flap after transfrontal craniotomy in a dog

A 10-year-old spayed female dog was referred for surgical removal of a brain tumor that had been identified following an acute onset of seizure activity 2 weeks earlier. A computed tomographic evaluation involving contrast agent revealed the presence of a contrast-enhanced mass within the left olfactory lobe of the brain. After removal of the mass via a transfrontal craniotomy, the overlying frontal bone flap was replaced and secured by use of a biologically inert rivet-like titanium clamp closure system and 3 titanium alloy craniotomy line clamps. On reevaluation 4 weeks after tumor removal, the dog was free of seizure activity and had no proprioceptive deficits; according to the owner, the dog had marked improvement in its overall behavior and attitude. The titanium clamp closure system appears to offer an effective and rapid technique for the secure replacement of craniotomy bone flaps in dogs.

Comparison of the Effects of the CO2 Surgical Laser and Conventional Surgical Techniques on Healing and Wound Tensile Strength of Skin Flaps in the Dog

Objective— To determine if CO2 laser was superior to conventional surgical techniques (CST) for creation of skin flaps in dogs as determined by hemostasis, wound healing, and wound tensile strength.Study Design— In‐vivo modelAnimals— Six large, mixed‐breed dogs.Methods— On each dog's trunk, 3 pairs of identical, dorsally based, pedicled skin flaps were created and sutured back into position. Based on a Latin Square design, flaps on one side were created with a CO2 laser and on the other side by CST. Intraoperative hemorrhage was measured by weighing sponges used to absorb blood. On days 7, 10, and 14, specimens from the flap‐skin junction and the central portion of each pair of flaps were collected. Specimens were subjected to tensile strength testing and histologic examination to evaluate wound healing.Results— Mean (± standard error of mean [SEM]) hemorrhage was significantly less (P= .02) with CO2 laser (4.70 ± 1.37 g) than CST (10.82 ± 1.37 g). Wound tensile strength (N/m2) after CST (0.49 ± 0.049) was significantly greater (P= .01) than with CO2 laser (0.17 ± 0.049). Laser incisions had partial necrosis of the wound edges and a more extensive inflammatory response; however, healing of the wound beds were similar regardless of technique.Conclusions— The CO2 laser provided better intraoperative hemostasis than CST. However, overall healing and increase in tensile strength of the skin‐flap junction of the flaps created by the laser may be delayed during the first few weeks of wound healing.Clinical Relevance— Skin flaps used to repair large skin defects in dogs can be created and elevated with a CO2 laser. In areas of increased skin mobility or tension, skin flaps created with CO2 laser may be more susceptible to complications such as dehiscence, and care should be taken to minimize these complications.

Effects of epidural anesthesia on microcirculatory blood flow in free medial saphenous fasciocutaneous flaps in dogs.

To assess the effects of epidural anesthesia using lidocaine on microcirculatory blood flow, volume, and velocity in free fasciocutaneous flaps in dogs. Study Design-In vivo experimental investigation. Animal Population-Ten adult dogs weighing 20 to 25 kg. A medial saphenous fasciocutaneous free flap was removed and an orthotopic transfer was performed by anastomosing the primary flap vessels back to the medial saphenous vessels. Blood flow (mL(LD)/min/100 g), volume (%volume or tissue hematocrit) and velocity (mm/s) in the flap were recorded throughout the procedure. After epidural anesthesia, blood flow, volume, and velocity values were again recorded. Microcirculatory blood flow, volume, and velocity, as measured by a laser-Doppler flowmeter, failed to reveal any significant changes over time. Immediately after epidural anesthesia, mean arterial pressure was significantly reduced and remained depressed throughout the experimental procedure. Epidural anesthesia combined with general anesthesia does not improve microcirculatory flow in free flaps in the pelvic limbs of dogs. No significant change in blood flow to the medial saphenous fasciocutaneous free flap occurred after division and anastomosis of the vascular pedicle. We recommend that epidural anesthesia with 2% lidocaine be used with caution in dogs undergoing microvascular free-flap transfer.