Combined omental pedicle grafts and thoracodorsal axial pattern flaps for the reconstruction of chronic, nonhealing axillary wounds in cats

OBJECTIVE To assess the results of an omental pedicle graft in combination with a thoracodorsal axial pattern flap for the reconstruction of chronic nonhealing axillary wounds in 10 cats caused by forelimb entrapment within a collar. STUDY DESIGN A prospective, clinical trial. ANIMALS USED: Ten client-owned domestic shorthair cats. METHODS Routine biochemical and hematologic evaluation was performed on each cat, and all were tested for feline immunodeficiency virus (FIV) and feline leukemia virus (FeLV). Microbial culture was performed on samples from the wounds. After surgical debridement, omentalization using a vascular pedicle of greater omentum, and closure of the chronic axillary wounds, using a thoracodorsal axial pattern flap, was performed. All excised tissue was examined histologically. RESULTS The sex distribution was 7 males and 3 females, with a mean age of 3.5 years. The cats had undergone a median number of 3 previous repair attempts over a 1.5- to 25-month period before referral (mean, 10.2 months). No hematologic or biochemical abnormalities were noted apart from moderately elevated creatine kinase and aspartate transaminase concentrations in some cats. All cats were negative for FIV and FeLV. Histologic examination of resected tissue revealed hair (foreign body) in 2 cats and an unidentified foreign-body reaction in 3 other cats. Complete healing occurred in all cats (mean follow-up period of 21.7 months), with 2 cats requiring further surgery: 1 for flap dehiscence at 4 days after surgery, and 1 for donor-site dehiscence at 4 days after surgery. One other cat developed a large seroma in the axilla that resolved by 10 days following surgery. CONCLUSION The use of an omental pedicle graft in combination with a thoracodorsal axial pattern flap is the first consistently successful 1-step technique for the management of chronic nonhealing axillary wounds in cats.