Advertisement
Research Article| Volume 60, ISSUE 5, P536-542, May 2007

Formation of a reliable capsular flap in a rat model

  • M.C. Schuringa
    Correspondence
    Corresponding author. Work: Reinier de Graaf Ziekenhuis, Department of Plastic Surgery, Postbus 5011, 2600 GA Delft, The Netherlands. Tel.: +31 15 2603940/2603441; fax: +31 15 2603901. Private: Bloemcamplaan 22, 2244 ED Wassenaar, The Netherlands. Tel.: +31 70 3833942.
    Affiliations
    Department of Plastic Surgery, Radboud University Nijmegen Medical Center, University of Nijmegen, Reinier Postlaan 4, P.O. Box 9101, Nijmegen 6500 HB, The Netherlands
    Search for articles by this author
  • E.H.M. Hartman
    Affiliations
    Department of Plastic Surgery, Radboud University Nijmegen Medical Center, University of Nijmegen, Reinier Postlaan 4, P.O. Box 9101, Nijmegen 6500 HB, The Netherlands
    Search for articles by this author
  • P.Q. Ruhé
    Affiliations
    Department of Plastic Surgery, Radboud University Nijmegen Medical Center, University of Nijmegen, Reinier Postlaan 4, P.O. Box 9101, Nijmegen 6500 HB, The Netherlands
    Search for articles by this author
  • J.A. Jansen
    Affiliations
    Department of Periodontology and Biomaterials, Radboud University Nijmegen Medical Center, University of Nijmegen, Reinier Postlaan 4, P.O. Box 9101, Nijmegen 6500 HB, The Netherlands
    Search for articles by this author
  • P.H.M. Spauwen
    Affiliations
    Department of Plastic Surgery, Radboud University Nijmegen Medical Center, University of Nijmegen, Reinier Postlaan 4, P.O. Box 9101, Nijmegen 6500 HB, The Netherlands
    Search for articles by this author

      Summary

      Prefabrication can be used to produce capsular flaps; other researchers have confirmed the feasibility of such flaps.
      Before the possibilities of capsular flaps can be explored, a reliable method to create these flaps has to be established first.

      Methods

      To produce capsular flaps in a rat model, the femoral vascular bundle was sandwiched between two silicone sheets. Three different methods were used and described. The capsule that formed between the two silicone sheets receives its main blood supply from that vascular pedicle. In this way pedicled capsular flaps were created. These flaps were used as a carrier for a skin graft, thus pre-laminating them, to test their ability for reconstructive surgery.
      The results of the three different methods of creating capsular flaps in a rat model were described and their results were evaluated. Especially the amount of capsule formation and the viability of the skin grafts was observed and compared.
      The feasibility of pre-laminated capsular flaps is confirmed and the most reliable method of creating them is described.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of Plastic, Reconstructive & Aesthetic Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Yajima H.
        • Kobata Y.
        • Kawamura K.
        • et al.
        Radial forearm flaps for reconstruction in hand surgery.
        Scand J Plast Reconstr Surg Hand Surg. 2004; 38: 112-117
        • Rogachefsky R.A.
        • Mendietta C.G.
        • Galpin P.
        • et al.
        Reverse radial forearm fascial flap for soft tissue coverage of hand and forearm wounds.
        J Hand Surg [Br]. 2000; 25: 385-389
        • Petrolati M.
        • Delaria G.
        • Abbiati G.
        • et al.
        Observations on the use of radial forearm (Chinese) and posterior interosseous reverse pedicled island flaps in hand surgery.
        Plast Reconstr Surg. 1991; 88: 175-177
        • Govila A.
        • Sharma D.
        The radial forearm flap for reconstruction of the upper extremity.
        Plast Reconstr Surg. 1990; 86: 920-927
        • Germann G.
        • Busching K.
        • Wittemann M.
        Two modifications of the radial forearm flap for reconstruction of complex facial defects.
        J Reconstr Microsurg. 1999; 15: 489-493
        • Santamaria E.
        • Granados M.
        • Barrera-Franco J.L.
        Radial forearm free tissue transfer for head and neck reconstruction: versatility and reliability of a single donor site.
        Microsurgery. 2000; 20: 195-201
        • Evans G.R.
        • Schusterman M.A.
        • Kroll S.S.
        • et al.
        The radial forearm free flap for head and neck reconstruction: a review.
        Am J Surg. 1994; 168: 446-450
        • Evans H.B.
        • Lampe H.B.
        The radial forearm flap in head and neck reconstruction.
        J Otolaryngol. 1987; 16: 382-386
        • Chen H.C.
        • Tang Y.B.
        Anterolateral thigh flap: an ideal soft tissue flap.
        Clin Plast Surg. 2003; 30: 383-401
        • Kaplan J.L.
        • Allen R.J.
        • Guerra A.
        • et al.
        Anterolateral thigh flap for breast reconstruction: review of the literature and case reports.
        J Reconstr Microsurg. 2003; 19: 63-68
        • Kuo Y.R.
        • Seng-Feng J.
        • Kuo F.M.
        • et al.
        Versatility of the free anterolateral thigh flap for reconstruction of soft-tissue defects: review of 140 cases.
        Ann Plast Surg. 2002; 48: 161-166
        • Cooper R.L.
        • Brown D.
        Pretransfer tissue expansion of a scalp free flap for burn alopecia reconstruction in a child: a case report.
        J Reconstr Microsurg. 1990; 6: 339-343
        • Hallock G.G.
        Free flap donor site refinement using tissue expansion.
        Ann Plast Surg. 1988; 20: 566-572
        • Kobienia B.J.
        • Migliori M.
        • Schubert W.
        Preexpanded radial forearm free flap to the scalp.
        Ann Plast Surg. 1996; 37: 629-632
        • Miyawaki T.
        • Degner D.
        • Jackson I.T.
        • et al.
        Easy tissue expansion of prelaminated mucosa-lined flaps for cheek reconstruction in a canine model.
        Plast Reconstr Surg. 2002; 109: 1978-1985
        • Pribaz J.J.
        • Fine N.A.
        Prefabricated and prelaminated flaps for head and neck reconstruction.
        Clin Plast Surg. 2001; 28 ([vii]): 261-272
        • Pribaz J.J.
        • Fine N.
        • Orgill D.P.
        Flap prefabrication in the head and neck: a 10-year experience.
        Plast Reconstr Surg. 1999; 103: 808-820
        • Millesi W.
        • Rath T.
        • Millesi-Schobel G.
        • et al.
        Reconstruction of the floor of the mouth with a fascial radial forearm flap, prelaminated with autologous mucosa.
        Int J Oral Maxillofac Surg. 1998; 27: 106-110
        • Rath T.
        • Millesi W.
        • Millesi-Schobel G.
        • et al.
        Mucosal prelaminated flaps for physiological reconstruction of intraoral defects after tumour resection.
        Br J Plast Surg. 1997; 50: 303-307
        • Rath T.
        • Tairych G.V.
        • Frey M.
        • et al.
        Neuromucosal prelaminated flaps for reconstruction of intraoral lining defects after radical tumor resection.
        Plast Reconstr Surg. 1999; 103: 821-828
        • Lauer G.
        • Schimming R.
        • Gellrich N.C.
        • et al.
        Prelaminating the fascial radial forearm flap by using tissue-engineered mucosa: improvement of donor and recipient sites.
        Plast Reconstr Surg. 2001; 108: 1564-1572
        • Khouri R.K.
        • Upton J.
        • Shaw W.W.
        Principles of flap prefabrication.
        Clin Plast Surg. 1992; 19: 763-771
        • Yao S.T.
        Vascular implantation into skin flap: experimental study and clinical application: a preliminary report.
        Plast Reconstr Surg. 1981; 68: 404-410
        • Jennings D.A.
        • Morykwas M.J.
        • DeFranzo A.J.
        • et al.
        Analysis of silicone in human breast and capsular tissue surrounding prostheses and expanders.
        Ann Plast Surg. 1991; 27: 553-558
        • Schnur P.L.
        • Weinzweig J.
        • Harris J.B.
        • et al.
        Silicone analysis of breast and periprosthetic capsular tissue from patients with saline or silicone gel breast implants.
        Plast Reconstr Surg. 1996; 98: 798-803
        • Peters W.
        • Smith D.
        • Lugowski S.
        • et al.
        Analysis of silicone levels in capsules of gel and saline breast implants and of penile prostheses.
        Ann Plast Surg. 1995; 34: 578-584
        • Bengtson B.P.
        • Ringler S.L.
        • George E.R.
        • et al.
        Capsular tissue: a new local flap.
        Plast Reconstr Surg. 1993; 91: 1073-1079
        • Itoh Y.
        An experimental study of prefabricated flaps using silicone sheets, with reference to the vascular patternization process.
        Ann Plast Surg. 1992; 28: 140-146
        • Thomson H.G.
        The fate of the pseudosheath pocket around silicone implants.
        Plast Reconstr Surg. 1973; 51: 667-671
        • Heymans M.
        • Lengele B.
        • Lahlali N.
        • et al.
        A peri-implant capsule flap.
        Br J Plast Surg. 1993; 46: 456-459
        • Lee H.B.
        • Lew D.H.
        De novo induction of island capsule flap by using two silastic sheets: part 1. Generation.
        Plast Reconstr Surg. 1999; 104: 1023-1028
        • Schoeller T.
        • Lille S.
        • Stenzl A.
        • et al.
        Bladder reconstruction using a prevascularized capsular tissue seeded with urothelial cells.
        J Urol. 2001; 165: 980-985