Delay Effect of PGE1 on Rat Transverse Rectus Abdominis Musculocutaneous Flap

ABSTRACT

This study was designed to find an effective delay method for preventing the ischemic compromise of TRAM flap in rat. Forty Sprague-Dawley rats were divided into 4 groups evenly and a left inferior epigastric vessel pedicled TRAM flap, sized 5.0 x 3.5 cm was created on the upper abdomen. Experimental groups included group 1(control) no delay procedure before elevation of flap, group 2(surgical delay) the left superior epigastric vessels and the contralateral rectus perforators were ligated 2 weeks before elevation of flap, group 3(pharmacological delay) prostaglandin E>(0.5 microgram) was given intraperitoneally for 2 weeks before elevation of flap daily, group 4(surgical and pharmacological delay) the same surgical and pharmacological delay have been done simultaneously. On the seventh day after operation, we evaluated and compared the results by the measurement of the flap survival area, the observation of the vessel distribution through Microfil casts and the measurement of vessel surface area through histologic slides. The results were as follows; 1) The mean percentages of the flap survival area of group 2(73.32+/-21.07%), 3(71.77+/-l 17.49%) and 4(89.54 +/-11.38%) were higher than that of group 1(41.23 +/- 14.26%) significantly(p < 0.05). 2) The vessel distributions of group 2, 3 and 4 were much abundant than that of group 1 in Microfil casts. 3) The vessel surface areas of group 2, 3 and 4 were higher than that of group 1 significantly(p < 0.01) and that of group 4 was higher than that of group 2(p < 0.05). In conclusion, prostaglandin E could be used to increase the flap survival area in rat TRAM flap model as a pharmacological delay and the effect of prostaglandin E was comparable to that of the surgical delay.