CAUDAL AURICULAR AXIAL PATTERN FLAP

Axial pattern flaps are pedicle grafts which incorporate a direct cutaneous artery and vein at their base. The cutaneous branch of the caudal auricular artery is the direct cutaneous artery for the caudal auricular axial pattern flap. The direct cutaneous artery and vein extend along the length of the flap for a variable distance and the terminal branches supply the subdermal, cutaneous, and subpapillary plexuses. The caudal auricular axial pattern flap is indicated for reconstruction of wounds of the ipsilateral head, face, and periocular region.

In a 2015 study investigating the outcome of axial pattern flaps in 49 dogs and 24 cats, postoperative complications were reported in 89% of animals. The most common complications included dehiscence (50% of axial pattern flaps in dogs and 75% of axial pattern flaps in cats), flap swelling (43% of axial pattern flaps in dogs and 50% of axial pattern flaps in cats), necrosis (46% of axial pattern flaps in dogs and 15% of axial pattern flaps in cats), infection (27% of axial pattern flaps in dogs and 40% of axial pattern flaps in cats), non-infectious discharge (14% of axial pattern flaps in dogs and 45% of axial pattern flaps in cats), and seroma (23% of axial pattern flaps in dogs and 20% of axial pattern flaps in cats). While the complication rate associated with axial pattern flaps is high, all of these complications were managed with either simple revisions (e.g., debridement and resuture) or conservatively (e.g., antibiotics, bandages, or monitoring). Overall, 93% of wounds were successfully reconstructed with an axial pattern flap. The flap outcome was assessed as excellent in 23%, good in 41%, fair in 30%, and poor in 7% of animals. The outcome following reconstruction using a caudal auricular axial pattern flap was not specifically stated in this study, but two small studies have reported results following wound reconstruction with a caudal auricular axial pattern flap. In a 1996 study, no complications and 100% healing were reported in three cats. In a 2003 study of three cats and one dog treated a caudal auricular axial pattern flap following orbital exenteration, necrosis of the distal aspect of the flap was reported in 50% of these animals. The mean area of survival of caudal auricular axial pattern flaps in dogs was 85.2% in a 1991 experimental study.

Case 1 - Periocular Soft Tissue Sarcoma