Misapplication of Subcutaneous Pedicle Flaps in the Dog

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Abstract
Subcutaneous pedicle flaps were created in 21 dogs, 1) with an intact underlying panniculus muscle, 2) with a severed panniculus muscle, and 3) devoid of an underlying panniculus muscle. The survival rates of the resultant grafts were evaluated over a minimum of ten days. All 19 subcutaneous pedicle flaps survived when the underlying panniculus muscle was intact. Nineteen of 23 flaps with a severed panniculus muscle, however, developed necrosis. The survival rates between these two groups were significantly different (p < 0.01). Eight of 14 flaps developed without an underlying panniculus muscle underwent necrosis. Their survival rate was significantly different from flaps with an intact panniculus muscle (p < 0.01) but not significantly different from flaps without an intact panniculus muscle (p < 0.1). Four of 23 subcutaneous pedicle flaps with severed panniculus muscles and six of 14 flaps without an underlying panniculus muscle survived, despite apparent vascular compromise. Six of these grafts survived by accidental incorporation of a direct cutaneous artery and vein beneath the graft. Results from this experiment indicate that subcutaneous pedicle flap development in the dog has a high incidence of necrosis unless a panniculus pedicle to the overlying skin is preserved. As such, they have no advantage in the dog over safer and simpler closure techniques, which preserve the cutaneous circulation.

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