The Effects the Composite Differences of the Transferred Vascular Tissues and the Surgical Delay on the Vascularization of the Prefabricated Cutaneous Flap.

Kim, Sang Bum; Won, Chang Hoon; Dhong, Eun Sang; Han, Seung Kyu; Park, Seung Ha; Kim, Woo Kyung; Kim, Young Jo; Lee, Byung Il

Original Article

Journal of the Korean Society of Plastic and Reconstructive Surgeons 2005;32(3):327-334.
Published online May 1, 2005.

The Effects the Composite Differences of the Transferred Vascular Tissues and the Surgical Delay on the Vascularization of the Prefabricated Cutaneous Flap.

Sang Bum Kim, Chang Hoon Won, Eun Sang Dhong, Seung Kyu Han, Seung Ha Park, Woo Kyung Kim, Young Jo Kim, Byung Il Lee

¹Department of Plastic & Reconstructive Surgery College of Medicine, Korea University, Seoul, Korea. guro@korea.ac.kr
²Orange Plastic and Aesthetic Surgery Clinics, Korea.

Abstract

This study was designed to investigate the effect of the surgical delay in the prefabricated cutaneous flap. Abdominal skin flaps (n=40), 4.5x6.0cm in size, were created by the subcutaneous implantation of a saphenous vascular tissue in the male Sprague-Dawley rats. In the groups 1 and 2, the pedicle was skeletonized. In the groups 3 and 4, perivascular muscle cuff or gracilis fascia was retained, respectively. Six weeks later, each flap was elevated as an island flap and reposed in place. All flaps of the group 2 had a 72-hours of delay period. Five days after the flap repositioning, estimation of flap viability, microangiographies, and histological evaluation of vessel development were performed. The groups 2 and 3 showed higher viability in flap survival. The dilated choke vessels and fully developed vascular network were observed in the flap of the group 2, but not typically seen in the other groups. New vessels around the implanted pedicle were more developed in the group 2. Amount of the vessels in the mid-portion of the flap was significantly increased in the groups 2 and 4. In conclusion, the delay procedure enhanced the viability, and its effect was dependent on the new vessel formation around the implanted pedicle.

Keywords: Prefabricated cutaneous flap; Pedicle implantation; Surgical delay