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KMID : 0381219810130040055
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Journal of RIMSK
1981 Volume.13 No. 4 p.55 ~ p.60
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An Experimental study for the Delay Phenomenon on Neurovascular Island Flap
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Abstract
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Necrosis of the skin flap can be catastrophe in reconstructive surgery. and then survival of flap is still a major problem in recontructive surgery. To increase the flap survival. traditionally. larger or risky random skin flap are prepared by a surgical delay procedures. where a portion of the vascular and nerve supply to a skin flap is interrupted.
However. microcirculatory mechanism that account for the dela phenomenon are not fully explained. Ischemia, sympathectomy and yervation super-sensitivity of arteriovenous shunts has been implicated as critical factor during the surgical delay phenomenon. No study has been seperated the drelative effects of ischemia vs. denervation or sort out the relative contribution to the delapy henomenon provided by arterial, venous, or neural supply to the skin-all of simultaneously or independently divided in the surgical delay of the random pattern f lap.
Our experimental model consist of a skin flap of complete abdominal wall of arat, raised as an island flap based on the left superficial epigastric neurovascular bundle, which prior manpulation of arterial. venous, or neural supply in contralateral neurovascular bundle to.determine any possible effects of each on the surviving skin flap area and analyzing the circulation to skin flap.
The result of this experiment revea that increased flap survival can be produced by a delay involving denervation alone (leaving vasular supply intact) or by devascularization alone (leaving the nerve supply intact), and sutained vasodilatation-vascular smooth muscle relaxation-is the vascular mechanism that account for the delay phenomenon.
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