Summary
One problem in the treatment of degloving injuries is the accurate prediction of the
survivability of the avulsed tissue. Initial evaluation frequently underestimates
the degree of eventual flap loss, and in many cases, there is a progressive necrosis
that continues over the ensuing days. The pathophysiology of this phenomenon is unclear.
We undertook this study to test the theory that underlying devascularised fat contributes
to overlying skin necrosis.
A dorsal random skin flap model was used in the rat. Sixty-six rats were divided into
three groups: flaps with viable fat and silicone sheeting underneath, flaps with devascularised
fat and silicone sheeting underneath and control flaps with only silicone sheeting
underneath. Flap necrosis (% area±SEM) was evaluated at one week, and found to be 27.1±4% in the live fat group, 33.2±4% in the dead fat group and 33.6±5% in the control group. One-way analysis of variance showed no statistically significant
difference between the three groups at a power of 80%.
In this study, we have shown that neither live nor dead fat has a significant influence
on the survival of an overlying random skin flap in the rat.
Keywords
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References
- Degloving injuries of the extremities and torso.J Trauma. 1981; 21: 835-839
- Vacuum-assisted closure for the treatment of degloving injuries.Plast Reconstr Surg. 1999; 104: 2145-2148
- Avulsion injury of the digits and hand.in: Tubiana The hand. vol. 2. WB Saunders, Philadelphia1985: 429-438
- Degloving injuries in children.J Pediatr Orthop. 1986; 6: 193-197
- Closed degloving injuries: results following conservative surgery.Plast Reconstr Surg. 1992; 89: 853-855
- Missed closed degloving injuries: late presentation as a contour deformity.Plast Reconstr Surg. 1996; 98: 334-337
- Massive degloving injury of the trunk.Am J Emerg Med. 1986; 4: 233-234
- The effect of cold ischemia on the patency of microvascular repair following arterial avulsion injury.Plast Reconstr Surg. 1995; 96: 413-420
- Biochemical analysis of the venous flap in the dog.J Surg Res. 1992; 53: 24-29
- The nature and extent of histopathologic injury in human avulsed arteries and veins and in experimentally avulsed monkey arteries.Plast Reconstr Surg. 1986; 78: 801-810
- A morphological study of the long-term repair process in experimentally stretched but unruptured arteries and veins.Br J Plast Surg. 1996; 49: 34-40
- A study of the extent and pathology of experimental avulsion injury in rabbit arteries and veins.Br J Plast Surg. 1985; 38: 278-287
- Diagnosis and management of closed internal degloving injuries associated with pelvic and acetabular fractures: the morel-lavallee lesion.J Trauma. 1997; 42: 1046-1051
- The management of lower extremity degloving injuries.Ann Plast Surg. 1981; 6: 1-5
- Degloving injuries. A retrospective study at the University Hospital Rotterdam.Acta Chir Belg. 1992; 92: 209-212
- Vacuum-assisted closure in the treatment of degloving injuries.Ann Plast Surg. 1999; 42: 589-594
- High-voltage electrical injury: chronic wound evolution.Plast Reconstr Surg. 1988; 82: 1027-1041
- The significance of resection length on the patency rate, and the histopathology, of experimentally avulsed and microsurgically repaired blood vessels.Br J Plast Surg. 1988; 41: 509-514
- The design of a pedicle flap in the rat to study necrosis and its prevention.Plast Reconstr Surg. 1965; 35: 177
- The dorsal skin-flap model in the rat: factors influencing survival.Plast Reconstr Surg. 1993; 91: 316-321
- Standardization of the dorsal rat flap model.Ann Plast Surg. 1983; 11: 210-213
- G power: a priori, post-hoc and compromise power analyses for MS-DOS.Department of Psychology, Bonn University, 1992
- Pathogenesis of skin flap necrosis from an underlying hematoma.Plast Reconstr Surg. 1979; 63: 540-545
Article info
Publication history
Published online: May 24, 2006
Accepted:
October 19,
2005
Received:
October 22,
2004
Footnotes
☆Supported by the Microsurgery Foundation, Melbourne, Australia.
Identification
Copyright
© 2006 The British Association of Plastic Surgeons. Published by Elsevier Inc. All rights reserved.
