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P rac T ica L T ec H ni QU e S
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ea.
MANAGEMENT OF COMPLICATIONS
Seromas, hematomas, and wound dehiscence are
potential postoperative complications seen after
extensive reconstructive surgery such as described in
this article (Figure 13).
• When a seroma or hematoma forms, do not invade
the wound; consider cage rest and hot packing the
wound beginning several days after surgery.
• c onsider early reconstruction of minor wound
edge dehiscence if there are no signs of infection.
• The distal aspect of the flap is most susceptible to
avascular necrosis and dehiscence. d ebride necrotic
tissue and manage the wound open until a healthy
granulation tissue bed forms. The surgeon can
decide to leave the wound open for second intention
healing or attempt secondary closure.
PROGNOSIS
i f performed correctly, c S e axial pattern flaps have
a low risk for flap necrosis (< 10%) and infection.
Minor complications, such as seroma, partial
incisional dehiscence, flap edema, and bruising, are
generally amenable to conservative management and
do not affect long-term prognosis.
c S e = caudal superficial epigastric
Suggested Reading
a per r L, Smeak dd . c linical evaluation of caudal superficial
epigastric axial pattern flap reconstruction of skin defects in
10 dogs (1989-2001). JAAHA 2005; 41(3):185-192.
c ampbell BG. Skills laboratory: How to perform a caudal
superficial epigastric flap. a vailable at veterinarymedicine.
dvm360.com/skills-laboratory-how-perform-caudal-
superficial-epigastric-flap?rel=canonical.
Pavletic MM. Atlas of Small Animal Wound Management and
Reconstructive Surgery, 3rd ed. a mes, ia : Wiley-Blackwell,
2010, pp 357-401.
Pavletic MM. c audal superficial epigastric arterial pedicle
grafts in the dog. Vet Surg 1980; 9(3):103-107.
d aniel d . S M eak
Daniel D. Smeak, DVM, Diplomate
ACVS, a soft tissue surgeon, is currently
professor and Chief of Surgery and
Oral Surgery at Colorado State
University. He has written an extensive
list of clinical and research articles, as
well as textbook chapters in the realm
of soft tissue surgery and core surgical
skills instruction. Dr. Smeak's passion is
teaching, and he is currently creating a
complete set of interactive web-based
core surgical skills modules to help
train future veterinary students and
practitioners around the world.