Computed tomographic imaging and mechanical analysis of cellophane banding secured with locking polymer clips for portosystemic shunts in canine cadavers.

OBJECTIVE To determine whether cellophane banding secured with locking polymer clips on cadaveric splenic veins would cause less CT imaging artifact and achieve equivalent mechanical strength, compared with cellophane banding secured with metal vascular clips. ANIMALS 10 canine cadavers. PROCEDURES Clips of each material were applied to each cadaver in a crossover design study. Triple-layer cellophane bands secured with 4 medium-large or large polymer or metal clips were placed on cadaveric splenic veins and evaluated by use of CT. Beam-hardening artifact was assessed by artifact length, attenuation, and a subjective grading scale ranging from 1 to 3 for mild to severe imaging artifacts. Secured cellophane bands were mechanically tested to determine force-deformation curves and yield forces. Findings for clip methods were compared with a 1-way ANOVA with a Tukey post-test. RESULTS For metal clips, beam-hardening artifact lengths and subjective artifact grades were significantly higher, whereas attenuation values were significantly lower, than findings for polymer clips. Polymer clips were significantly lower in strength than metal clips with mean ± SD yield loads of 1.9 ± 0.6 N (medium-large polymer clips), 2.8 ± 1.3 N (large polymer clips), 6.0 ± 1.9 N (medium-large metal clips), and 8.4 ± 2.7 N (large metal clips). CONCLUSIONS AND CLINICAL RELEVANCE Use of locking polymer clips to secure cellophane banding resulted in less CT imaging artifact and mechanical strength, compared with use of metal vascular clips. Use of locking polymer clips may allow improved assessment of postoperative CT imaging in dogs with extrahepatic portosystemic shunts, which warrants in vivo clinical evaluation.

Versatility of the Angularis Oris Axial Pattern Flap for Facial Reconstruction.

OBJECTIVE: To describe the versatility of the axial pattern flap based on the cutaneous perforating branch of the angularis oris artery for reconstruction of large facial defects in dogs, including complications and clinical outcomes. STUDY DESIGN: Retrospective clinical case series. ANIMALS: Client-owned dogs (n = 8). METHODS: Facial flaps (n = 9) based at the commissure of the lip with a caudodorsal orientation were utilized, with established anatomical borders. Flaps were elevated deep to the panniculus carnosus in a caudal to rostral direction, preserving the angularis oris artery, its cutaneous perforator, and surrounding cutaneous vasculature. Flaps were rotated dorsally or ventrally to cover the defect. Primary closure of the donor site was by direct apposition in all cases. RESULTS: Angularis oris axial pattern flaps were most commonly used to close large defects of the nasomaxillary area rostral to the eyes (6 dogs), followed by orbital (2) and intermandibular (1) defects. Defects occurred because of tumor resection (6 dogs), trauma (2), and a chronic, non-healing wounding (1). All flaps healed with acceptable functional and cosmetic outcomes without major complications. Followup ranged from 10 days to 16 months. Minor postoperative complications included flap edema (8 dogs), partial incisional dehiscence (3), distal tip necrosis (2), and oroantral fistula recurrence (1). CONCLUSION: Angularis oris axial pattern flaps provided hirsute, full-thickness skin coverage of a variety of large facial defects with minor complications, and should be considered when restructuring large defects of the rostral face or chin.