Perfusion, viability, and pedicle dependence in acute and delayed rat island skin flaps

✍ Scribed by Ewa Komorowska-Timek; Tomasz A. Timek; Sandra Brady; Harry J. Buncke

• Publisher: John Wiley and Sons
• Year: 2007
• Tongue: English
• Weight: 190 KB
• Volume: 27
• Category: Article
• ISSN: 0738-1085
• DOI: 10.1002/micr.20319

✦ Synopsis

Abstract

Purpose: Although surgical delay phenomenon has been widely investigated, its pathophysiology has not been fully elucidated. Methods: In 25 Spraque–Dawley rats, an 8 × 8 cm^2^ epigastric skin flap consisting of 4 vertical zones A through D (farthest from vascular pedicle) was outlined. All animals were perfused twice with colored fluorescent microspheres: immediately before and after flap elevation (Acute, n = 10) and before and after pedicle ligation on POD 8 (Delayed, n = 15). Results: After acute flap elevation, peripheral perfusion dropped significantly in zone C (0.29 ± 0.01 vs. 0.19 ± 0.04 ml g^−1^ min^−1^; P < 0.01) and zone D (0.33 ± 0.09 vs 0.01 ± 0.01 ml g^−1^ min^−1^; P < 0.01), while global flap perfusion remained unchanged. Total and regional blood flow did not change in the Delayed group after pedicle ligation. Conclusions: Elevation of a pedicled flap caused significant decrease in distal flap perfusion while maintaining proximal and total flap perfusion. Eight‐day delay was adequate to establish sufficient flap perfusion independent of the vascular pedicle. © 2007 Wiley‐Liss, Inc. Microsurgery, 2007.