Retrospective comparison of axial pattern and subdermal plexus flaps in canine reconstructive surgery: Surgical outcomes, complications, and factors associated with wound dehiscence.

Background and Aim: Axial pattern flaps (APFs) and subdermal plexus flaps (SPFs) are widely used reconstructive techniques for managing extensive skin defects in dogs. Although APFs are traditionally considered more reliable because of their direct vascular supply, comparative clinical data between APFs and SPFs remain limited. This study retrospectively compared surgical outcomes, postoperative complications, and factors associated with wound dehiscence in dogs undergoing reconstructive surgery using APFs or SPFs. Materials and Methods: Medical records of dogs that underwent reconstructive skin flap surgery at the Kasetsart University Veterinary Teaching Hospital, Thailand, between July 2013 and July 2025 were retrospectively reviewed. Data collected included flap type, patient demographics, hematologic and biochemical parameters, surgical indications, wound locations, drainage methods, postoperative complications, and healing outcomes. A total of 85 skin flaps from 78 dogs were analyzed, including 32 APFs and 53 SPFs. Wound dehiscence and postoperative complications were compared between groups using appropriate statistical analyses. Results: Wound dehiscence occurred in 31/85 flaps (36.5%), with no significant difference between APFs (37.5%) and SPFs (35.8%) (p = 1.000). Overall postoperative complications were observed in 61% of flaps and were comparable between APFs and SPFs (65.6% vs. 58.5%, p = 0.513). Mass removal was the primary indication for reconstruction (81.2%). Distal limb reconstructions showed the highest dehiscence rates in both flap types, whereas ventral body and perineal flaps demonstrated lower dehiscence rates. Passive drains showed higher dehiscence frequencies than active drainage systems. Necrosis was strongly associated with wound dehiscence in both APFs and SPFs, while edema and discharge were additionally associated with dehiscence in APFs and SPFs, respectively. Preoperative hematologic and biochemical abnormalities, body weight, sex, age, and granulation tissue were not significantly associated with surgical outcomes. Conclusion: APFs and SPFs demonstrated comparable clinical outcomes and complication rates in canine reconstructive surgery. Postoperative complications, particularly necrosis, were strongly associated with wound dehiscence. Careful flap selection, meticulous surgical technique, appropriate drainage management, and close postoperative monitoring are essential to optimize reconstructive outcomes, especially in anatomically challenging regions such as the distal limbs.