A vaginal mucosal pedicle flap technique for repair of rectovaginal fistula in mares

Abstract

Objective - To describe the use of a vaginal mucosal pedicle flap for repair of rectovaginal fistulae (RVF) in mares. Study Design - Clinical case report. Animals - Three mares with RVF. Methods - After debriding the RVF, a dorsally based U-shaped mucosal and submucosal pedicle flap (2-4 mm thick) was dissected from the vaginal wall, rotated approximately 90° angle to close the ventral aspect of the fistula and sutured in position with 10-13 single sutures that did not penetrate the rectal mucosa. This positioned the vaginal mucosa so that it was continuous with the rectal mucosa. Results - Two RVF healed by 1st intention whereas for the 3rd RVF, 2 additional single sutures were required to repair partial dehiscence after 10 days. At 6 weeks and 6 months all RVF were healed. One mare subsequently foaled without complications. Conclusions - RVF can be closed by use of a rotation flap of vaginal tissue. Clinical Relevance - Tension-free closure of RVF can be achieved by rotating a pedicle flap of vaginal mucosal tissue without undue wound tension, and should be considered as an alternative to conventional appositional techniques. © Copyright 2004 by The American College of Veterinary Surgeons.