Skin fold flaps for the rescue!
Shownotes
This Week's Episode: A Look Back — 1995 and the Skin Fold Advancement Flap
This week we travel back three decades to revisit a foundational paper in small animal reconstructive surgery: Geraldine Hunt's 1995 description of the skin fold advancement flap for closing large sternal and inguinal wounds in dogs and cats. Before this technique was described, surgeons facing large ventral defects in these regions had limited options beyond skin grafts or leaving wounds to heal by second intention — both often impractical in mobile, high-tension areas like the groin and chest.
Hunt's insight was elegant: the flank fold (near the inguinal region) and the elbow fold (near the sternum) are natural double-layered skin folds with a robust subdermal blood supply, fed by the deep circumflex iliac artery and lateral thoracic artery respectively. By dividing the fold's attachments to the limb, "unfolding" it into a single U-shaped flap, and advancing it into the defect, surgeons could achieve reliable, tension-free coverage using local tissue — with a donor site simple enough to close primarily. Nearly 30 years later, this technique remains a workhorse in general and specialty practice, and it laid the groundwork for later refinements, including Hunt's own 2001 follow-up extending the approach to proximal limb and trunk defects more broadly.
Reference:
Hunt GB. Skin fold advancement flaps for closing large sternal and inguinal wounds in cats and dogs. Veterinary Surgery. 1995;24(2):172–175. Link: https://onlinelibrary.wiley.com/journal/1532950x
The Veterinary Surgery Podcast is a first of its kind podcast that focuses on surgical advance in veterinary medicine with host Dr. Jolle Kirpensteijn. Jolle is a diplomate of the American and European Colleges of Veterinary Surgery and has lots of experience in veterinary surgery. Jolle will interview fellow surgeons, review articles that are recently published and will discuss 2 books he will be working on in the near future. You can also follow Jolle on his Global Veterinary Surgery Facebook or Instagram pages.
This week we travel back three decades to revisit a foundational paper in small animal reconstructive surgery: Geraldine Hunt's 1995 description of the skin fold advancement flap for closing large sternal and inguinal wounds in dogs and cats. Before this technique was described, surgeons facing large ventral defects in these regions had limited options beyond skin grafts or leaving wounds to heal by second intention — both often impractical in mobile, high-tension areas like the groin and chest.
Hunt's insight was elegant: the flank fold (near the inguinal region) and the elbow fold (near the sternum) are natural double-layered skin folds with a robust subdermal blood supply, fed by the deep circumflex iliac artery and lateral thoracic artery respectively. By dividing the fold's attachments to the limb, "unfolding" it into a single U-shaped flap, and advancing it into the defect, surgeons could achieve reliable, tension-free coverage using local tissue — with a donor site simple enough to close primarily. Nearly 30 years later, this technique remains a workhorse in general and specialty practice, and it laid the groundwork for later refinements, including Hunt's own 2001 follow-up extending the approach to proximal limb and trunk defects more broadly.
Reference:
Hunt GB. Skin fold advancement flaps for closing large sternal and inguinal wounds in cats and dogs. Veterinary Surgery. 1995;24(2):172–175. Link: https://onlinelibrary.wiley.com/journal/1532950x
The Veterinary Surgery Podcast is a first of its kind podcast that focuses on surgical advance in veterinary medicine with host Dr. Jolle Kirpensteijn. Jolle is a diplomate of the American and European Colleges of Veterinary Surgery and has lots of experience in veterinary surgery. Jolle will interview fellow surgeons, review articles that are recently published and will discuss 2 books he will be working on in the near future. You can also follow Jolle on his Global Veterinary Surgery Facebook or Instagram pages.