Regional axial pattern flaps may serve as a compromise between local and free flaps by providing durable tumor-free tissue for wound reconstruction. The availability of cervical and frontal cutaneous flaps with direct cutaneous blood supply for head and neck reconstruction may allow radical resective surgery avoiding functional disturbances while providing a cosmetic result.

Caudal Auricular (Lateral Neck) Flap has been shown to be a useful reconstructive surgical technique following resection of head and neck neoplasms in humans. The skin-muscle composite has versatility for multiple head and neck lesions allowing generous margins, less tissue bulk compared with other regional flaps, adaptable length, and vascular reliability. The feline and canine platysma muscle is intimately associated with subcutaneous tissues. Cutaneous vascular supply from multiple vessels, including cutaneous branches of the caudal auricular artery and vein are observed coursing in the lateral cervical region of the platysma muscle. As in humans, the observed vascular supply to the feline and canine lateral neck flap is consistent in location and emphasizes a cranial basis and horizontal orientation. There seems to be no deleterious results related to flap thinness or gravitational effects based on application in clinical patients.

Results of cadaver and vascular studies in the feline and canine show one cutaneous branch of the caudal auricular artery and vein contributing blood supply to the cranial aspect of the cervical skin and platysma muscle while angiography reveals dorsal and caudal vessel orientation which parallels the central cervical region. The cutaneous branch of the caudal auricular artery observed during surgery is intimately associated with the platysma muscle and divides near its origin located in the area between the lateral aspect of the wing of the atlas and the vertical ear canal. The flap is centered over the lateral aspect of the wing of the atlas. The flap is positioned in the center of the neck within ventral and dorsal lines paralleling the measured flap base and the same width measurement centered on the spine of the scapula. Flap length may vary and does not necessarily extend to the spine of the scapula.

Superficial Temporal (Forehead) Flap is used for reconstruction in the canine and feline maxillofacial region where the skin is relatively immobile, making cutaneous wounds often not amenable to primary repair or second intention wound management without resultant functional and cosmetic deficiencies. Human patients with maxillofacial defects have been successfully surgically managed using “forehead flaps” since as early as 700 BC. The scalping “forehead flap”, with the flap base at the level of the zygomatic arch, is similar to the flap described here.

Guidelines for flap location are based on results of cadaver and vascular studies performed in dogs and cats. The landmarks for the base of the forehead flap are the caudal aspect of the zygomatic arch caudally and the lateral orbital rim rostrally. Flap dimensions are based on the feasibility of primary wound closure of the donor site and required length to transfer the flap to the maxillofacial area, including the nasal planum as the rostral extent. The width of the flap is equivalent to the width of the zygomatic arch. Based on the necrosis of the distal tip of the extended 4:1 length:width ratio flaps, it is recommended to use a 3:1 length:width ratio forehead flap that provides adequate tissue for rostral rotation to the nasal planum.