Induction of Capsular Island Flap Using Two Silastic Sheets

ABSTRACT

The search for a new flap with minimal donor morbidity has been pursued by many plastic surgeons. Numerous donor sites available for microsurgical composite tissue transplantation have been described owing to the tremendous advances made in the field of microsurgery. To be suifable for use as a free flap, a sizable vessel must be included within the tissue, leading to significant donor morbidity. There have been studies for prefabrication of an axial pattern flap in an effort to create a new flap, but most of these methods relied solely on revascularization of a preexisting composite tissue. Our experiment, using an isolated femoral artery and vein as the main pedicle, led to formation of a capsule flap through a normal foreign body reaction between 2 silastic sheet implants. On this induced capsule flap, a skin graft was performed and a total of 40 axial pattern capsulo-cutaneous flaps from 20 Sprague-Dawley rats were successfully obtained after nearly 12 weeks through 4 stages of experiment, including a delay procedure at the second stage. Pathology revealed neovascularization, and abundantly impregnated vascular structures near the pedicle were observed along with random pattern collagen fibers. The skin graft took 100% on this newlyformed axial pattern capsular flap and thus implied that the capsule structure was able to survive on it`s own and was able to support skin grafts. This new flap using only the isolated artery and vein structure can be induced according to various needs with minimal donor morbidity.