Maximum Extension of the Greater Omental Flap by Subcutaneous Tunneling in Felines

Resumo

Background: The omentum is a vascularized organ with angiogenic and absorptive properties, making it valuable in veterinary surgery for tissue repair, infection control, and revascularization. In dogs, omental flaps have been extended to limbs and the brain, while in humans cadaveric studies demonstrated its reach to thoracic and limb regions. In cats, anatomical constraints such as omental length and mobility have limited its use in distant body regions. The objective of this study was to determine the maximum extension of the greater omentum flap in feline cadavers and evaluate its reach to pelvic and thoracic limbs, head, and tail using subcutaneous tunneling.

Materials, Methods & Results: Sixteen feline cadavers of varied age, weight, and body length were used, allowing assessment in a heterogeneous sample. The animals were obtained from natural deaths unrelated to this study. A pre-retro-umbilical median celiotomy was performed to access the omentum, which was exteriorized. From this structure, a single-layer “L”-shaped flap was created by incising 1/3 of its width while preserving the vascular pedicle. Subcutaneous tunnels were established toward target regions by blunt dissection between skin and musculature, with small incisions when necessary. The omentum was kept moist with saline throughout the procedure. Measurements were taken at each stage of flap creation and extension, including double-layer, single-layer, and post-tunneling lengths. The cadavers were divided into 4 groups according to the target region: pelvic limb, thoracic limb, head, and tail. In all cases, the greater omentum reached the proposed anatomical regions. Flap lengths ranged from 30 cm to 85 cm, with larger animals consistently exhibiting longer extensions, confirming correlation between body size and omentum length. Passage required wider tunnels in cadavers with higher fat content, and tunneling to the head proved more challenging in heavier animals due to the greater distance from the origin. Nevertheless, the technique remained feasible even in cadavers with a history of abdominal surgery, indicating that prior procedures did not necessarily compromise extension or vascular integrity.

Discussion: These findings show that subcutaneous tunneling allows the greater omentum to reach distant anatomical regions in cats while maintaining vascular integrity. The versatility of the flap highlights its potential use in reconstructive procedures, chronic wound management, and enhancement of local blood supply. Its surface area, flexibility, and vascularization make it suitable for wound healing in anatomically challenging areas, particularly distal limbs and cranial regions. Limitations must be considered: laparotomy creates communication between sterile and non-sterile areas, increasing contamination risk, and excess fat can complicate tunneling, requiring wider dissection and longer surgical time. Despite these challenges, the technique proved reproducible and safe in cadavers, supporting clinical application. Overall, the study confirmed the feasibility of the “L”-shaped omental flap in feline patients, providing a method to extend the omentum to previously inaccessible sites. These results reinforce the translational relevance of the technique, as similar approaches have been reported in canine and human models. Future studies are warranted to evaluate long-term outcomes, particularly in wound healing, bone vascularization, and management of chronic infections, supporting broader application in veterinary practice.

Keywords: cat, omentalization, pedicle, subcutaneous tunneling.