Reconstructive flaps in equine traumatology

All equine surgeons are presented with a case where wound closure is not possible after wounding or mass removal. In many cases, second intention wound healing is used to get these wounds to heal. However, in some instances, primary wound closure is preferred. This is especially true near the eye, ear, lips, or other important structures. Reconstructive flaps can be used in these cases to achieve primary wound closure. There are many types of flaps that can be used in equine wound care. The most important requirement for a reconstructive flap is that there is tissue adjacent to the wound or tissue defect that can be advanced or rotated into the tissue defect. It is desirable to be able to close the new defect, but it is not required. An example is a rotational flap on the head to cover a sinus or nasal fistula. The new wound side can be left open to heal by second intention in order to cover the bone defect. It is common to use tension relieving suture patterns with advancement and rotational flaps as it is very difficult to completely remove the tension when closing.

Sliding “H” plasty: The sliding “H” plasty can be performed with either one or two advancement flaps. It is a simple technique where a square or rectangular defect is created around a wound or mass and one or two flaps are undermined and advanced to close the defect. The length of the advanced tissue should never be more than 2 time longer than the width of the advance tissue. [...]