J Reconstr Microsurg 2017; 33(02): 112-117
DOI: 10.1055/s-0036-1593770
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Prefabricated Flaps: Identification of Microcirculation Structure and Supercharging Technique Improving Survival Area

Heng Xu*
1  Department of Plastic Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
,
Shaoqing Feng*
1  Department of Plastic Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
,
Yimeng Xia
2  Department of Anesthesiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
,
Zvi Steinberger
3  Department of Orthopaedic Surgery, Sheba Medical Center, Tel HaShomer, Israel
,
Wenjing Xi
1  Department of Plastic Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
,
Hongwei Fang
4  Department of Anesthesiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
,
Zhiwei Li
5  Department of Orthopaedic Surgery, Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
,
Yixin Xie
1  Department of Plastic Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
,
Yixin Zhang
1  Department of Plastic Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
› Author Affiliations
Further Information

Publication History

15 July 2016

24 August 2016

Publication Date:
17 November 2016 (online)

Abstract

Background Microcirculation is an important factor frequently overlooked when studying the survival of prefabricated flaps. In the current study, we use different prefabrication techniques for characterizing microcirculation within the flap, with the goal of finding an effective way to improve its survival area.

Methods An abdominal prefabricated flap rodent model was created using a two-stage operation. All rats were randomly divided into six groups (n = 10/group): group A, prefabricated femoral vessels; group B, prefabricated femoral artery with a connected superficial inferior epigastric vein (SIEV); group C, connected superficial inferior epigastric artery (SIEA) with a prefabricated femoral vein; group D was similar to group A along with a prefabricated SIEA, and group E was similar to group A along with a prefabricated SIEV; and group F acted as a control group and consisted of an axial flap nourished by superficial inferior epigastric vessels. Flaps were assessed for survival area, blood perfusion area, and capillary density using macroscopic analysis, near-infrared fluorescence imaging (NIFI), and histology.

Results The survival area was not significantly different when comparing groups B to C, and D to E. The survival area of groups D and E was larger than that of groups B and C. Groups B through E had a smaller survival area in comparison to group F and a larger survival area than group A. NIFI were consistent with the macroscopic outcomes. The capillary density was not significantly different between groups A to C and groups D to F.

Conclusion Both arterial and venous supercharging could potentially improve the survival area of prefabricated flaps.

* Both the authors contributed equally to this study.