Assessment of a caudal external thoracic artery axial pattern flap for treatment of sternal cutaneous wounds in birds

OBJECTIVE: To assess the use of a caudal external thoracic artery axial pattern flap to treat sternal cutaneous wounds in birds. ANIMALS: 16 adult Japanese quail. PROCEDURE: A cutaneous defect in the region of the mid-sternum was surgically created in all quail. In 6 quail (group I), an axial pattern flap was created from the skin of the lateral aspect of the thorax and advanced over the sternal defect. In 8 quail (group II), a flap was similarly created and advanced but the flap vasculature was ligated. All quail were euthanatized at 14 days after surgery and had necropsies performed. Sections of the flap and the surrounding tissue were examined histologically to assess flap viability. RESULTS: All axial pattern flaps in group-I quail had 100% survival. In group II, mean percentage area of flap survival was 62.5%; mean area of necrosis and dermal fibrosis of flaps were significantly greater than that detected in group I. In flaps of group-II quail, neovascularization in the deep dermis and profound necrosis of the vascular plexus in the superficial dermis were observed. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that the caudal external thoracic artery axial pattern flap could be used successfully in the treatment of surgically created sternal cutaneous defects in quail with no signs of tissue necrosis or adverse effects overall. Use of this technique to treat self-mutilation syndromes or application after surgical debulking of tumors or other masses might be beneficial in many avian species.