The effects of optimizing blood inflow in the pedicle on perforator flap survival: A pilot study in a rat model.

Olariu, Radu; Moser, Helen Laura; Lese, Ioana; Sabau, Dan; Georgescu, Alexandru Valentin; Grobbelaar, Adriaan Ockert; Constantinescu, Mihai Adrian (2020). The effects of optimizing blood inflow in the pedicle on perforator flap survival: A pilot study in a rat model. Archives of plastic surgery, 47(3), pp. 209-216. Korean Society of Plastic and Reconstructive Surgeons 10.5999/aps.2019.00871

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BACKGROUND

Perforator flaps have led to a revolution in reconstructive surgery by reducing donor site morbidity. However, many surgeons have witnessed partial flap necrosis. Experimental methods to increase inflow have relied on adding a separate pedicle to the flap. The aim of our study was to experimentally determine whether increasing blood flow in the perforator pedicle itself could benefit flap survival.

METHODS

In 30 male Lewis rats, an extended posterior thigh perforator flap was elevated and the pedicle was dissected to its origin from the femoral vessels. The rats were assigned to three groups: control (group I), acute inflow (group II) and arterial preconditioning (group III) depending on the timing of ligation of the femoral artery distal to the site of pedicle emergence. Digital planimetry was performed on postoperative day (POD) 7 and all flaps were monitored using laser Doppler flowmetry perioperatively and postoperatively in three regions (P1-proximal flap, P2-middle of the flap, P3-distal flap).

RESULTS

Digital planimetry showed the highest area of survival in group II (78.12%±8.38%), followed by groups III and I. The laser Doppler results showed statistically significant higher values in group II on POD 7 for P2 and P3. At P3, only group II recorded an increase in the flow on POD 7 in comparison to POD 1.

CONCLUSIONS

Optimization of arterial inflow, regardless if performed acutely or as preconditioning, led to increased flap survival in a rat perforator flap model.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Plastic and Hand Surgery > Plastic, Reconstructive and Aesthetic Surgery
04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Plastic and Hand Surgery

UniBE Contributor:

Olariu, Radu; Lese, Ioana; Grobbelaar, Adriaan Ockert and Constantinescu, Mihai Adrian

Subjects:

600 Technology > 610 Medicine & health

ISSN:

2234-6163

Publisher:

Korean Society of Plastic and Reconstructive Surgeons

Language:

English

Submitter:

Veronika Picha

Date Deposited:

09 Jun 2020 08:55

Last Modified:

09 Jun 2020 09:04

Publisher DOI:

10.5999/aps.2019.00871

PubMed ID:

32453928

Uncontrolled Keywords:

Animal experimentation Perforator flap Surgery, plastic

BORIS DOI:

10.7892/boris.144353

URI:

https://boris.unibe.ch/id/eprint/144353

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