ABSTRACT
When a perforator flap is transposed in pedicled fashion, twisting, tension, or both
can be inflicted on the pedicle. Although high density twisting undoubtedly decreases
flap survival, the effect of pedicle tension with or without twisting has not been
studied for perforator flaps. The authors designed a model of nonanastomotic pedicle
tension using a cranial epigastric perforator flap in rats. Sprague-Dawley rats were
divided into 4 groups—control, twist, tension, tension plus twist groups; each group
consists of 10 rats. Tension group had lower flap survival ratios than control and
the flap survival ratio of tension plus twist group was lower than those of the other
groups (p < 0.05). Pedicle tension was found to decrease perforator flap survival and its detrimental
effect was exacerbated by twisting. Surgeons need to have a lower threshold for correction
of pedicle tension when twisting is combined than without a twist.
KEYWORDS
Pedicled perforator flap - pedicle tension - pedicle twisting
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Goo-Hyun MunM.D.
Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School
of Medicine
50 Irwon-dong, Gangnam-gu, Seoul 135-710, S. Korea
Email: supramicro@gmail.com
