The effects of the different tissue layer implantation of the vascular tissues on the survival of prefabricated flaps

ABSTRACT

The prefabrication by vascular induction into random patterned flaps is a method creating axial donor flap by implantation of nourishing pedicles prior to harvesting random patterned flaps. The purpose of this study was to evaluate the viability of a thin prefabricated flap prepared by the subdermal implantation of fasciovascular pedicles without subcutaneous tissue or muscular layer, by comparing with the prefabrication by the subpanniculus carnosus implantation of vascular pedicles, which is well known to a predictable survival rate by many authors. In the left abdomen of 40 Sprague-Dawley rats, the fasciovascular pedicles were implanted in the subdermal layer in group I(n=20) and sub panniculus carnosus layer in group II(n=20), respectively. 5 weeks later, 4 x 6 cm sized abdominal flap was elevated with implanted vascular pedicle as an island and reposed immediately. At the same time, in the right abdomen, conventional island flap was elevated and reposed. After 3 days later, the evaluation of the survival area was carried out in each side, in both groups. The mean proportions of the survival areas in group I were 74.2 and 91.8% in the prefabricated and conventional flap, respectively. And those in group II were 76.4 and 91.2% in the prefabricated and conventional flap, respectively. These results showed that there is no difference in the proportion of survival area between two types of prefabrication. In conclusion, it is possible to prefabricate a thin axial-patterned fascioutaneous flap without subcutaneous tissue and the viability of this prefabricated flap is reliable as much as that of other prefabricated flaps having subcutaneous or muscular tissue.