FACIAL AXIAL PATTERN FLAP

Axial pattern flaps are pedicle grafts which incorporate a direct cutaneous artery and vein at their base. There are two direct cutaneous arteries supplying the facial axial pattern flap: transverse facial artery and cutaneous branch of the masseteric artery, and these also anastomose with angularis oris artery and dorsal and ventral labial arteries. 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 facial axial pattern flap is indicated for reconstruction of wounds of the ipsilateral face and nose.

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 facial axial pattern flap was not reported in this study, but the outcome was excellent in another study of four dogs with wounds reconstructed with a facial axial pattern flap.

Case 1 - Dehiscence Following Resection of a Lip Mast Cell Tumor

Last updated on 6th March 2017