A proposed technique for one-step preputial reconstruction in the dog

Objective To describe a reverse axial pattern flap based on the superficial branch of the dorsal penile artery and describe its use in preputial reconstruction. Materials and Methods Ten penises were harvested from canine cadavers; five were used to describe the dermatome supplied by the superficial branch of the dorsal artery of the penis and five to show perfusion of the skin flap. The superficial branch of the dorsal artery of the penis was identified fluoroscopically by injecting contrast material into the dorsal artery of the penis. This artery was then catheterised and injected with methylene blue to identify the perfused area. A skin flap was created by making a full thickness skin incision at the level of the fornix, along the circumference of the penis. The flap was developed by pulling the cut end toward the tip of the penis while undermining the skin. The flap was considered long enough when the cut end of the flap reached the level of the urethral opening. We also describe a case of preputial resection and reconstruction using this flap. Results Injection of methylene blue demonstrated the arterial supply to the skin flap. This flap was successful in treating the clinical case following resection of a mast cell tumour on the prepuce, although a small area of full thickness flap necrosis, which healed by second intention, developed postoperatively. Clinical Importance This technique may be useful for single step preputial reconstruction.