Page 51 - BSAVA Manual of Canine and Feline Head, Neck and Thoracic Surgery, 2nd Edition

Thoracic Surger
V
y
A Manual of Canine and F
eline Head,
Neck and
BSA
BSAVA Manual of Canine and Feline Head, Neck and Thoracic Surgery
OPERATIVE TECHNIQUE 3.4
VetBooks.ir plit palatal flap techni ue

PATIENT POSITIONING
Dorsal recumbency. The head is positioned so that the palate is parallel to the table. The mouth is taped open to permit
optimal visualization during surgery.
ASSISTANT

Optional.

ADDITIONAL INSTRUMENTS
Periosteal elevator.

SURGICAL TECHNIQUE
Approach
The epithelial margins of the defect are debrided with a No. 15 scalpel blade. Then the mucoperiosteum of the hard
palate is incised, creating two flaps of unequal length rostral to the defect, separated from each other in the midline.

Surgical manipulations
1 Raise the mucoperiosteal flaps A and B with a periosteal elevator. The transected major palatine arteries at the
rostral extent of the flaps may require ligation. Caudal elevation of the flaps must be performed with caution as
the palatine arteries are the only major blood supply to the flaps.
2 Rotate the shorter flap (B) through 90 degrees and transpose it to cover the defect.

3 Suture the medial aspect of flap B to the caudal aspect of the palatal defect, and the tip of the flap to the lateral
aspect of the palatal defect, using synthetic absorbable material.
4 Rotate the longer flap (A) through 90 degrees and transpose it rostral to flap B.
5 Suture the medial aspect of flap A to the edge of flap B.

The margins of The The shorter flap
the defect are mucoperiosteal B is rotated
debrided and flaps are raised through
t o flaps of ith a degrees and
une ual periosteal sutured over the
length are elevator. defect. The longer
created rostral flap is rotated
to the defect. B through
A
degrees and
sutured to the
B edge of flap B.
B
A A

Closure
PRACTICAL TIP
The denuded rostral aspect of the palate from which the
Leaving a short strip of connective tissue in the
flaps were harvested is left to heal by secondary intention. midline allows the underside of the longer flap (A)
to be sutured to the bone, thus reducing
POSTOPERATIVE CARE excessive gaping of the flap and potential food
entrapment in this area
Soft food for 2 weeks.

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