|
KMID : 0358819860130020129
|
|
Journal of Korean Society of Plastic and Reconstructive Surgeons
1986 Volume.13 No. 2 p.129 ~ p.138
|
|
|
EXPERIMENTAL STUDY FOR DETERMINATION OF TIMING OF DISTANT FLAP PEDICLE DIVISION IN RATS
|
|
Choi Ou-Kyu
Ahn Sang-Tae
Lim Poong
Lee Chong-Kun
|
|
|
Abstract
|
|
|
Distant flaps have been widely used in reconstructive surgery and the timing of division of the flap pedicle has been determined by rather conventional concept and surgeon’s experience than any objective criteria.
It has been classical concept that the pedicle should not be divided until two to three weeks after the flap transfer. But in clinical experience of many surgeons, an interval of three weeks is not necessary in gaining an adequate blood supply from its recipient bed.
Purposes of the present experiment are to determine the earliest time when a flap pedicle can be safely divided, and to find the way how it can be correctly assessed.
Cephalad-pedicled flaps (3 x 6 cm) were prepared in backs of 70 albino rats weighing 200 to 250 gm which was the maximal length of the flap and that was expected to result in 100% survival.
Blood flow was measured in proximal, middle and distal areas of the flap using Laser Doppler velocimetry before the flap elevation and every day after the operation for 6 days.
The pedicles of the flaps were divided after the blood flow measurements, and mean flap survival areas were measured as percentage of the total flap area on the fifth day after pedicle division.
Microangiographic studies were also performed in each day to study revascularization within the flap and the change of blood vessels around the flap margins.
The results were as follows:
1. The blood flow measurements revealed marked reduction at the 1st postoperative day and they returned almost normal at the 3rd postoperative day in the proximal area and at the 5th postoperative day in the middle and distal areas.
2. The flap survival after division of the pedicles is thought to be correlated to the blood flow of the flap especially at the distal area.
3. The microangiographic examination suggests that reorganization and reorientation of the blood vessel in the flap are more important than revascularization around the flap margin in regard to the flap survival after pedicle division.
4. Adequate time of pedicle division of distant flap is thought to be when blood flow of the flap especially at the distal area return almost to the level before the flap elevation.
|
|
|
KEYWORD
|
|
|
|
|
|
FullTexts / Linksout information
|
|
|
|
|
|
Listed journal information
|
|
  
|