Investigation and clinical application of a novel axial pattern flap for nasal and facial reconstruction in the dog.
OBJECTIVE
To describe the vascular supply to a facial skin flap based at the commissure of the lip in the dog and report on its use in four dogs.


METHODS
Experimental and prospective clinical study. Animals Five canine cadavers and four client-owned dogs.


METHODS
In the cadavers, the ventral aspect of the zygomatic arch, the ventral margin of the caudal mandible and the wing of the atlas were marked as anatomical boundaries of a skin flap that was elevated from the subcutaneous tissues to the level of the medial canthus of the eye. Methylene blue dye and barium sulphate solution were independently infused through a common carotid (three dogs) or facial artery (two dogs) catheter. Distribution of dye throughout the harvested skin was assessed subjectively. After contrast infusion the flap was excised and radiographed. The technique was used to reconstruct large facial or nasal defects in four dogs after tumour or skin lesion excision.


RESULTS
Cadaver dissections and contrast studies clearly demonstrated three direct cutaneous arteries, the superior and inferior labial arteries and the angularis oris artery, arborising within the base of the flap. A separate direct cutaneous branch of the angularis oris artery was identified. An arterial plexus was identified within the distal flap, within which this artery communicates with the transverse facial artery and a cutaneous branch of the masseteric artery. Dye infusion caused discolouration of the elevated skin and vasculature within the flap. The flap survived in all clinical cases with marginal distal necrosis in one dog.


CONCLUSIONS
The complex facial flap described is perfused by three direct cutaneous arteries and functions reliably in clinical cases.
Yates
G
G
The University of Melbourne Veterinary Clinical Centre, Werribee VIC 3030, Australia. gyates@unimelb.edu.au
Landon
B
B
Edwards
G
G
D000818:Animals; D002102:Cadaver; D004285:Dogs / Q000601:surgery*; D005145:Face / Q000601:surgery*; D005260:Female; D008297:Male; D009666:Nose / Q000601:surgery*; D011446:Prospective Studies; D019651:Plastic Surgery Procedures / Q000379:methods / Q000662:veterinary*; D016038:Skin Transplantation / Q000379:methods / Q000662:veterinary*; D013524:Surgical Flaps / Q000098:blood supply / Q000662:veterinary*