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Microsurgery. 2007;27(2):146-51.

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

Author information

1
Division of Plastic and Reconstructive Surgery, Loma Linda University, Loma Linda, CA 92354, USA. etimek@sbcglobal.net

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 x 8 cm2 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.

PMID:
17290377
DOI:
10.1002/micr.20319
[Indexed for MEDLINE]

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