Axial pattern and myocutaneous flaps

Question 1

Define axial pattern flap

Answer 1

Incorporates a direct cutaneous artery and vein

Question 2

Omocervical
Supply
Origin
Borders

Answer 2

Cervical cutaneous branch of the omocervical a and v

Prescap LN and goes dorsally

Caudal incision acromion along the spinous process
Cranial incision parallel to the caudal incision equidistant to the scapular spine (same landmarks cat or dog)

Question 3

Thoracodorsalaxial pattern flap
Supply
Origin
Borders

Answer 3

Cutaneous branch of the thoracodorsal a and v

Caudal to the shoulder at the level of the accordion and courses dorsally to the level of the spin of the scapula

Caudal incision - parallel to the cranial incision eqidistant to the scapular spine
Cranial incision - from the acromion and goes dorsally along the spine
Fun facts - same in dog/cat, elevate under cutaneous trunci, can make an L flap, 70% tip necrosis in dogs, 98% successful in cats

Question 4

dorsal deep circumflex iliac axial pattern flap

supply
origin
borders

Answer 4

dorsal branch of the deep circumflex iliac

ventral extent of the cranial edge of the wing of the ilium

caudal incision - midway between the wing of the ilium and the greater trochanter and extending dorsally
cranial incision - parallel to the caudal incision equidistant to the iliac wing
Fun facts - elevate under cutaneous trunci,

Question 5

ventral deep circumflex iliac axial pattern flap

supply
origin
borders

Answer 5

ventral branch of the deep circumflex iliac

ventral extent of the cranial edge of the wing of the ilium

caudal incision - distal along the cranial border of the femur
cranial incision - parallel to the caudal

fun facts - same in dogs and cats

Question 6

caudal superficial epigastric axial pattern flap

supply
origin
borders

Answer 6

caudal superficial epigastric a and v

inguinal canal

medial incision - midline starting behind the last teat (w max length being second mammary gland)
lateral incision - parallel to midline and equidistant to the teat

fun facts - undermine and take the supramammerius muscle, 30% dehiscence, 95% survival in dogs

Question 7

angularis oris axial pattern flap

supply
origin
borders

Answer 7

angularis oris artery and tributaries of the facial and inferior/superior labial arteries
labial commisura and caudal buccal margins
dorsal incision - rostrally at the point level with the caudal margin of the commissar and parallel with the ventral border of the zygomatic arch, then extended along the border or the zygomatic arch caudally to a point over the vertical ear canal.
ventral incision - rostrally at the point level with the caudal margin of the commissar and parallel with the ventral border of the mandibular ramus, then extended along the border of the zygomatic arch caudally to a point over the vertical ear canal.
fun facts - be careful with underlying structures - facial nerve, auriculotemporal nerve, parotid duct

Question 8

superficial temporal axial pattern flap

supply
borders

Answer 8

superficial temporal a and v

caudal - caudal aspect of the zygomatic arch
rostral - lateral orbital rim

fun facts - superficial branch of the rostral auricular nerve gets cut, but it does not affect eyelid function. survival 93% in dogs, 99% in cats. Survival is 69% if it extends to the other zygomatic arch (not recommended).

Question 9

caudal auricular axial pattern flap

supply
origin
borders

Answer 9

sternocleidomastoideus branches of the caudal auricular a and v

depression between the wing of the atlas and the base of the vertical ear canal

dogs - central third of the lateral cervical region over the wing of the atlas
cats - dorsal incision is dorsal midline

length is to the spin of the scapula

fun facts - 85% survival in dogs, maybe more in cats, shorter flaps have fewer complications