Summary
Reverse-flow flaps are currently particularly used for the reconstruction of defects
of the distal part of the extremities. Despite their common usage there have been
many reports of postoperative complications, especially resulting in partial or total
flap necrosis. There is insufficient knowledge of flap haemodynamics, physiology and
wound healing properties in reverse-flow flaps. Development of the proper experimental
models is needed to investigate these issues. The purpose of this study was to describe
a new reverse-flow flap model in the rat. A total of 20 adult Wistar rats weighing
200–250 g were used in this experiment. In five rats, the vascular anatomy of the auricle
of the rat was determined by anatomic dissection and microangiography. In the experimental
group (N=5), 1×1 cm reverse-flow composite flaps were harvested as a semi-island shape, based on the
distal course of the medial branch of the anterior auricular artery. In the control
group, consisting of five rats, the flap was designed and raised based on the proximal
course of the medial auricular artery, again in a semi-island shape. In the remaining
five animals, a square-shaped composite tissue of the whole layer of the auricle,
1×1 cm in size, was harvested dividing all the bases circumferentially. The composite
tissue was replaced in situ. While the former was considered a conventional antegrade-flow
flap subgroup, the latter was designated as a graft subgroup. All flaps were replaced
in situ. The survival of the flap was evaluated on postoperative day 7 by direct observation
and microangiography. The skin island of all the reverse-flow flaps and conventional
antegrade-flow flaps survived completely giving a success rate of 100%, whereas all
grafts in the control group underwent complete necrosis. Microangiographic studies
revealed the vascularity of the reverse-flow and antegrade-flow flaps, identifying
the course of the auricular arteries. In conclusion, with its evident advantages of
easy to design and harvesting, reliable survival pattern and consistent vascular structure,
our new flap model will provide a means for future studies on flap haemodynamics,
physiology in reverse-flow flaps.
Keywords
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Article info
Publication history
Published online: May 24, 2006
Accepted:
January 18,
2006
Received:
October 15,
2004
Identification
Copyright
© 2006 The British Association of Plastic Surgeons. Published by Elsevier Inc. All rights reserved.
