Reconstructive Surgery: Subdermal Plexus Flaps

Preservation of blood supply is crucial for success in reconstructive surgery. In dogs and cats, direct cutaneous arteries emerge from deep tissues, turn parallel to the skin, and run in the cutaneous muscle, sending innumerable branches (the subdermal plexus) to the overlying dermis and epidermis (Fig. 1). To preserve blood supply when undermining the edges of a wound or raising a flap, dissect immediately deep to (dashed line) the cutaneous muscle. This preserves the blood supply to the elevated skin. Do not be fooled by the layer of subcutaneous tissue that may be between the cutaneous muscle and the dermis; undermining in this superficial fat cuts off the skin’s blood supply ...