A retrospective study published in the Journal of the American Veterinary Medical Association (JAVMA) has found that while subdermal plexus skin flaps in dogs and cats are associated with a relatively high complication rate, most cases still achieve good-to-excellent outcomes. The findings provide a clearer picture of how these commonly used reconstructive techniques perform in clinical practice.
The study methodology
The study reviewed medical records for 73 patients at the Queen Mother Hospital for Animals. The records comprised 53 dogs and 20 cats that underwent a total of 92 subdermal plexus skin flap procedures between 2000 and 2017. The authors assessed indications for surgery, flap types used, complications and overall outcomes.
Note: This was a retrospective study conducted in a referral setting, which may limit how directly the findings apply to first-opinion practice. The long study period (2000–2017) also means that surgical techniques and perioperative care may have evolved over time. As with all retrospective analyses, results depend on the completeness and accuracy of clinical records.
The results
Tumour excision was the most common indication for subdermal plexus flap use, accounting for 37 of 92 procedures (40%). Chronic wound reconstruction made up 28 cases (30%), acute wounds 14 cases (15%), surgical scar revision seven cases (8%) and other reasons six cases (7%). Advancement flaps were the most commonly used technique, followed by axillary fold and inguinal fold flaps.
Complications were recorded after 47 of the 92 procedures, giving an overall complication rate of 51%. Most were minor (37%), while 14% were classified as major. Complications typically became apparent around one week postoperatively, with a mean onset of 6.9 days.
Despite this, overall outcomes were positive. Results were rated as excellent in 48% of procedures and good in 36%, meaning 84% achieved a good-to-excellent outcome. Fair outcomes were reported in 14% of cases and poor outcomes in 2%.
The bottom line for practice teams
For vets with an interest in soft tissue surgery, subdermal plexus flaps represent a useful and relatively accessible reconstructive option, particularly following tumour excision or wound management. However, they are not without risk. Practices should plan for postoperative complications, ensure appropriate follow-up, and set realistic expectations with clients from the outset.
Read the full study here: Jones CA, Lipscomb VJ. Indications, complications, and outcomes associated with subdermal plexus skin flap procedures in dogs and cats: 92 cases (2000–2017). Journal of the American Veterinary Medical Association. 15 October 2019.
