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tvpjournal.com | September/October 2016 | T O day' S Ve T erinary Prac T ice P rac T ica L T ec H ni QU e S F r OM TH e na V c in ST i TUT e Peer r eviewed 69 The caudal superficial epigastric ( c S e ) flap is a highly versatile axial pattern skin flap that can be used to cover large open wounds (Figure 1, page 70) on the: • i psilateral or contralateral mid to caudal trunk • Perineum • Hindlimbs (to some extent). i n dogs with greater body length-to-limb length ratios (such as basset hounds) and cats, this flap can extend to cover wounds as distal as the metatarsus. This extensive range of skin transfer is due to the long, robust c S e artery, which branches from the external pudendal artery in the caudal part of the inguinal canal; then continues cranially just deep to the mammary glands along the mammary row (Figure 2, page 70). When creating the flap, once the cranial, medial, and lateral aspects of the flap have been freed, most of the skin of the mammary chain can be elevated from the abdominal fascia and effectively transferred to distant skin defects. The donor skin defect can then be closed routinely, similar to closure after a unilateral mastectomy. INDICATIONS d ue to the flap's abundant blood supply and skin with thick subcutaneous tissue padding, the flap can be used to successfully cover: • d eep wounds without a granulation bed • Wounds with exposed bone or tendon • a reas that require durable full-thickness skin coverage. The most common indications for c S e axial pattern flaps are (Figures 3–5, page 71): • Large degloving injuries to the hindlimb • Large skin defects after wide surgical excision of neoplasia. GENERAL PREOPERATIVE CONSIDERATIONS • Perform thorough physical examination and obtain a minimum database, including complete blood count and serum biochemical profile. Wound Manage M ent: Caudal Superfi C ial e piga S tri C f lap Daniel D. Smeak, DVM, Diplomate ACVS Colorado State University What You Will n eed » Standard surgical instrument pack » #10 or #15 scalpel blades » 3-0 or 4-0 monofilament absorbable sutures on a taper needle » 3-0 or 4-0 monofilament nonabsorbable sutures on a cutting needle » Many laparotomy sponges Optional but helpful: » Variety of skin hooks » Electrocoagulation Optional: » Jackson-Pratt drain bulb and multifenestrated tubing » Extra (8–10) small towel clamps » Atraumatic DeBakey thumb forceps Each year, the na VC i nstitute takes place in Orlando, Florida, and top specialists in select areas of veterinary medicine provide hands-on, one-on-one continuing education to Institute attendees in a multi-day "immersion learning" experience. The na VC and Today's Veterinary Practice have partnered together to present p ractical t echniques from the na VC i nstitute, which gives our readers insight into the unique education provided at the Institute through articles published in the journal. This article reviews information from the session, p ractical t echniques in Soft t issue Surgery, presented at the NAVC Institute 2015. The NAVC Institute 2017 will take place in Orlando, Florida, May 21 to 26; visit navc.com/institute for further information.