Veterinary Surgery Podcast

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.

Dr Jolle is back with a short episode because he will be in NYC this week. He is discussing Chapter 10 of his new reconstruction book, focusing on complications in reconstructive surgery. He also looks at some news about veterinary surgery in the various general journals.  More info about his book: https://www.routledge.com/Colour-Atlas-of-Reconstructive-Techniques-in-the-Dog-and-Cat/Kirpensteijn-Stanley-terHaar/p/book/9780367029999

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 episode of the Vet Surgery Podcast hosted by Dr. Jolle Kirpensteijn is featuring Dr. Elizabeth Maxwell (Assistant Professor of Surgical Oncology, University of Florida) and Dr. Federico Vilaplana Grosso (Associate Professor in Diagnostic Imaging, University of Florida), who co-authored a recent JAVMA article.
Topic: Differentiating 360° GDV from Simple Gastric Dilatation The discussion centered on the caudal esophageal "twist sign" — a funnel-shaped appearance in the lower esophagus that helps identify 360-degree gastric dilatation-volvulus (GDV), which is notoriously difficult to distinguish from regular gastric dilatation on radiographs.
Key findings from the study: The research compared 29 dogs with 360° GDV to 38 dogs with simple gastric dilatation. The twist sign was present in all dogs with esophageal dilation, except when the esophagus had been decompressed by tube placement. Unlike typical 180° GDV cases (which show classic signs like abnormal pylorus positioning), 360° twists return the stomach to its normal anatomic position, making radiographic diagnosis much harder. 
Clinical perspectives: Dr. Maxwell noted that unsuccessful oral gastric tubing and endoscopy attempts were more common in 360° cases. Dr Vilaplana Grosso shared that the funnel sign was not part of his standard diagnostic approach before collaborating with Dr. Maxwell. The group discussed differing institutional practices on whether to image first or decompress first in emergency GDV situations. 

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.

In this episode of the Veterinary Surgery Podcast, Dr. Jolle Kirpensteijn sits down with repeat guest Dr. Sarah Boston, a veterinary cancer surgeon, for a wide-ranging conversation. They start with recent literature on staphylectomy techniques before turning to the contentious topic of continued French Bulldog breeding given the breed's well-documented health complications. Dr. Boston walks through her path into veterinary medicine, from deciding on the career at age six to finally landing a surgical residency on her third attempt. The discussion then moves into her own research contributions: a new diaphragmatic hernia repair technique she calls the "BostonPexy," which uses a kidney plug method, and a combined-approach mandibulectomy technique developed for large dogs. The episode closes with Dr. Boston naming the veterinary surgery papers that shaped her thinking most, citing Duncan Lascelles' work on maxillectomy approaches and Charles Koontz's research on vaccine-associated sarcomas.

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.

We are not done talking soft palate issues! As a follow up from last week I am discussing the folded flap versus traditional staphylectomy technique for treating brachycephalic airway syndrome in dogs with Dr. Bryden Stanley. Bryden shared her experience using folded flaps when palate thickness exceeds 1.2-1.5 centimeters on CT scans, particularly for patients who haven't responded to traditional staphylectomy. She emphasized the technique requires a robust suture pattern using interrupted 2.0 and 3.0 monocryl sutures and noted the learning curve involved. Jolle mentioned recent studies showing no significant difference between the two techniques, but Bryden argued the literature remains controversial and individual patient factors are crucial in determining the best approach. They discussed how variations in technique and patient selection could explain conflicting results in the current research.

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.