A vaginal mucosal pedicle flap technique for repair of rectovaginal fistula in mares

OBJECTIVE: To describe the use of a vaginal mucosal pedicle flap for repair of rectovaginal fistulae (RVF) in mares. STUDY DESIGN: Clinical case report. ANIMALS: Three mares with RVF. METHODS: After debriding the RVF, a dorsally based U-shaped mucosal and submucosal pedicle flap (2-4 mm thick) was dissected from the vaginal wall, rotated approximately 90 degrees angle to close the ventral aspect of the fistula and sutured in position with 10-13 single sutures that did not penetrate the rectal mucosa. This positioned the vaginal mucosa so that it was continuous with the rectal mucosa. RESULTS: Two RVF healed by 1st intention whereas for the 3rd RVF, 2 additional single sutures were required to repair partial dehiscence after 10 days. At 6 weeks and 6 months all RVF were healed. One mare subsequently foaled without complications. CONCLUSIONS: RVF can be closed by use of a rotation flap of vaginal tissue. CLINICAL RELEVANCE: Tension-free closure of RVF can be achieved by rotating a pedicle flap of vaginal mucosal tissue without undue wound tension, and should be considered as an alternative to conventional appositional techniques.