Caudal Superficial Epigastric Axial Pattern Flap and Stem Cell Therapy for the Management of Large Wound on Medial Aspect of Thigh in a Dog

Madhu Doddhadasarahalli Nanjappa^1*, Raja Aijaz Ahmad¹, Amarpal¹, Mudasir Bashir Gugjoo¹, Abhijit Motiram Pawde¹, Prakash Kinjavedkar¹, Hari Prasad Aithal¹, Matin Ansari², Vikash Chandra², Gutulla Taru Sharma^2
1Indian Veterinary Research Institute, Izatnagar, Uttar Pradesh, India; ²Division of Surgery and Department of Physiology and Climatology
*Corresponding author: madhu63vsr@gmail.com

ABSTRACT
An 11 year non–descript dog was presented with the history of severe dog bite injuries on left thigh, tibial and paw region with loss of large area of skin. The treatment was initiated and continued until the appearance of healthy granulation tissue and the skin grafting was planned. To make a caudal superficial epigastric axial pattern flap, a midline incision was given beginning just behind the last mammary teat incorporating the base of the prepuce and continued in a cranial direction to include three mammary teats. Thus a flap of 15x6cm was made and rotated to cover the medial thigh defect. The graft was anchored with subcutaneous tissue using 3–0 PGA and then apposed with the surrounding skin with 2–0 polyamide. A large wound was still left uncovered on distal tibial and paw region. Blood examination revealed that the dog was diabetic and uncovered wound didn’t show signs of healing, however, the grafted area showed signs of healing. The open wound was treated with local injection of 5x106 mesenchymal stem cells given twice at 12 days interval. The animal made an uneventful recovery in 50 days.

Key Words: Caudal superficial epigastric axial pattern flap, Stem cell therapy, Wound management