ABSTRACT
This study presents a technique that preserves osseous viability in prefabricated
osteocutaneous flaps with a soft-tissue vascular carrier, with a pedicled skin flap
acting as the vascular carrier to neovascularize a partially devascularized bone segment
before its transfer. Using a total of 50 New Zealand White rabbits, two groups were
randomized as experimental and control animals. In the experimental group (n = 30),
a bipedicled dorsal scapular skin flap was anchored with sutures to the scapular bone,
by bringing it into contact with the exposed dorsal surface of the bone after stripping
the dorsal muscular attachments. Following 4 weeks of neovascularization, the prefabricated
composite flaps were harvested, based on the caudally-based dorsal skin flap, after
stripping the ventral muscular attachments of the bone. In the control group (n =
20), non-vascularized scapular bone grafts were implanted under bipedicled dorsal
scapular skin flaps with sutures. After 4 weeks, prefabricated composite flaps were
harvested, based on the caudally-based dorsal skin flap. In both groups, on day 7
after the second stage, the viability of the bony component of the flaps was evaluated
by direct observation, scintigraphy, measurement of bone metabolic activity, microangiography,
dye injection study, and histology. Results indicated that the bone segments in the
experimental group demonstrated a greater survival than in the control group. The
authors conclude that this technique of osteocutaneous flap prefabrication preserves
the viability of the bony component with a soft-tissue vascular carrier, in contrast
to the conventional method of pre-transfer grafting. The technique may be useful clinically
in selected cases.
KEYWORDS
Osseous viability - prefabricated osteocutaneous flaps
