Deep circumflex iliac cutaneous free flap in cats.
OBJECTIVE
To develop and assess the survival of a microvascular cutaneous free flap based on the ventral branch of the deep circumflex iliac (DCI) artery and vein in cats.


METHODS
Experimental study.


METHODS
Phase 1: 6 feline cadavers; Phase 2: 2 adult cats; Phase 3: 10 adult cats.


METHODS
Phase 1: Selective angiographic study of the deep circumflex iliac artery was completed in 6 feline cadavers. After injection of the DCI artery with barium, high-detail radiographs were made of skin flaps harvested from the lateral flank and thigh region. The extent of the cutaneous angiosome was mapped with regard to the underlying anatomical landmarks. Phase 2: An island flap based on anatomic boundaries of the DCI angiosome derived from phase 1 of the study was elevated in 2 cats. Flaps were observed for 3 weeks for survival. Phase 3: Free skin flaps based on the DCI vessels were harvested in 10 cats and transferred to the dorsal interscapular region. Flaps were evaluated for 2 weeks for survival. Tissue samples were collected for histopathology, and angiograms of the flaps were completed.


RESULTS
Phase 1: Angiograms revealed a large primary cutaneous angiosome of the DCI artery located over the lateral femoral region, which extended from the iliac crest to the level of the patella. Phase 2: All island flaps survived for 3 weeks. Phase 3: Six free flaps survived for 2 weeks, and 4 flaps failed completely. Failure of 1 flap occurred because of avulsion of the venous and arterial anastomosis postoperatively. Another cat had intraoperative hemorrhage, which resulted in anemia and hypovolemia and likely caused the flap to fail. The other 2 flaps that failed had poor perfusion intraoperatively and had the longest ischemia times.


CONCLUSIONS
The cutaneous DCI free flap in cats may be clinically useful in reconstruction of large cutaneous wounds. The length of ischemia time for successful cutaneous free flap transfer in the cat may be shorter than in other species.


CONCLUSIONS
Large wounds created by trauma or oncologic ablative surgery in cats could be reconstructed with cutaneous microvascular free flap. Additional studies assessing the critical ischemia time of cutaneous flaps in cats and evaluating the use of this flap clinically are needed.
Jackson
Andrew H
AH
Michigan Veterinary Specialists, Southfield, MI 48076, USA.
Degner
Daniel A
DA
Jackson
Ian T
IT
Miyawaki
Takeshi
T
Silverberg
Boris
B
Bradford
Melinda
M
Andrus
Lee
L
D000792:Angiography / Q000662:veterinary; D000818:Animals; D002102:Cadaver; D002415:Cats / Q000601:surgery*; D007083:Iliac Artery / Q000502:physiology* / Q000601:surgery*; D012016:Reference Values; D012867:Skin / Q000098:blood supply*; D016038:Skin Transplantation / Q000379:methods / Q000662:veterinary; D013524:Surgical Flaps / Q000662:veterinary*