J Reconstr Microsurg 2009; 25(9): 533-538
DOI: 10.1055/s-0029-1234024
© Thieme Medical Publishers

The Influence of Pedicle Length on the Viability of Twisted Perforator Flaps in Rats

Cheol-Ho Chang1 , So-Young Lim1 , Jai-Kyong Pyon1 , Sa-Ik Bang1 , Kap-Sung Oh1 , Goo-Hyun Mun1
  • 1Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
Weitere Informationen

Publikationsverlauf

Publikationsdatum:
12. August 2009 (online)

ABSTRACT

The pedicled perforator flap is now regarded as a valuable tool in the reconstructive armamentarium, but variable degrees of perforator twisting upon flap transposition are frequently encountered intraoperatively. The aim of this study was to investigate the effect of pedicle length on twisted perforator flap viability. Forty Sprague-Dawley rats were randomly divided into four groups of 10 animals each: group I (short pedicle, no rotation), group II (short pedicle, 720 degrees rotation), group III (long pedicle, no rotation), and group IV (long pedicle, 720 degrees rotation), and cranial epigastric artery perforator flaps were elevated. Mean group flap survival ratios were 88.47 ± 13.87% (group I), 60.23 ± 28.95% (group II), 87.06 ± 13.85% (group III), and 84.28 ± 31.76% (group IV). Viable flap ratios in group II were significantly lower than in groups I, III, and IV, respectively (p < 0.05). Our findings suggest that when perforator twisting is unavoidable, longer pedicles are significantly more likely to result in secure flap survival.

REFERENCES

  • 1 Morris S F, Neligan P C, Taylor G I. Free style local perforator flaps. In: Blondeel PN, Morris SF, Hallock GG et al Perforator Flaps: Anatomy, Technique, and Clinical Application. St. Louis, MO; Quality Medical Publishing Inc 2006: 947-960
  • 2 Khouri R K. Avoiding free flap failure.  Clin Plast Surg. 1992;  19 773-781
  • 3 Ozbek M R, Deune E G, Cooley B C, Khouri R K. Experimental reproduction of free flap errors: a new model of thrombosis.  Ann Plast Surg. 1994;  32 474-477
  • 4 Atchabahian A, Masquelet A C. Experimental prevention of free flap thrombosis. I: A model of free flap failure.  Microsurgery. 1996;  17 710-713
  • 5 Izquierdo R, Dobrin P B, Fu K, Park F, Galante G. The effect of twist on microvascular anastomotic patency and angiographic luminal dimensions.  J Surg Res. 1998;  78 60-63
  • 6 Salgarello M, Lahoud P, Selvaggi G, Gentileschi S, Sturla M, Farallo E. The effect of twisting on microanastomotic patency of arteries and veins in a rat model.  Ann Plast Surg. 2001;  47 643-646
  • 7 Demirseren M E, Yenidunya M O, Yenidunya S. Island rat groin flaps with twisted pedicles.  Plast Reconstr Surg. 2004;  114 1190-1194
  • 8 Demir A, Acar M, Yldz L, Karacalar A. The effect of twisting on perforator flap viability: an experimental study in rats.  Ann Plast Surg. 2006;  56 186-189
  • 9 Wong C H, Cui F, Tan B K et al.. Nonlinear finite element simulations to elucidate the determinants of perforator patency in propeller flaps.  Ann Plast Surg. 2007;  59 672-678

Goo-Hyun MunM.D. 

Department of Plastic Surgery, Samsung Medical Center

Sungkyunkwan University School of Medicine, Irwon-dong 50, Gangnam-gu, Seoul, South Korea 135-710

eMail: gh.mun@samsung.com

    >