Abstract
Both surgical delay and ischemic preconditioning (IP) have been shown to be effective
in improving the survival of flaps. We used a variety of flap delay methods and IP
to increase the surviving area of the transverse rectus abdominis musculocutaneous
(TRAM) flap in rats, and the results are compared in between. A 6- × 3-cm–sized TRAM
flap in 40 Wistar rats was allocated into five groups. Group 1: TRAM flap was elevated
from nondominant pedicle, and the flap was sutured to the original bed. Group 2: Left
superior deep epigastric vessels (SDEV) were cut; 1 week later, TRAM flap was elevated.
Group 3: Only skin incision was done; 1 week later, TRAM flap was elevated. Group
4: Skin incision was done, and the left SDEV were cut; 1 week later, TRAM flap was
elevated. Group 5: TRAM flap was elevated; IP was performed using three cycles of
10 minutes of repeated ischemia/reperfusion (I/R) periods, and the flap was sutured
to the original bed. The surviving area of the flap was statistically significant
between the control and groups 2, 4, and 5 (p < 0.001), and groups 4 and 2 were superior to group 5. Although preconditioning has
been intensively studied for the last two decades and partly provided its beneficial
effects in I/R injury, we determined the IP increased the surviving area of the TRAM
flap but not effective as much as surgical delay method.
Keywords
ischemic preconditioning - surgical delay - TRAM flap
