ARTERIOVENOUS CROSS-FLOW FLAP IN RATS - A NOVEL SKIN FLAP

Angiosomes are blocks of tissues, composed of the integument and under lying deep structures, supplied and drained by a named artery and its accompanying vein. The purpose of the current study is to describe a n ew principle, which allows extension of the territory of an angiosome into tile adjacent angiosome, thus enabling the creation of a large sk in flap (arteriovenous cross-flow flap). Epigastric skin flaps, measur ing 8 x 8 cm, were raised in 30 Sprague-Dawley male rats. In group A ( single-pedicle flap), the flaps were based on the epigastric artery an d vein on the ipsilateral side, and the contralateral pedicle was divi ded. In group B (cross-flow flap), the epigastric vein on the ipsilate ral side and the epigastric artery an the contralateral side of the fl ap were divided. In group C (skin graft), the vascular pedicles were d ivided bilaterally. A definitive assessment was made on the seventh da y. Digital images of the flaps were analyzed using an imaging software and the areas of skin survival and necrosis were determined. Lead oxi de microangiogram was performed in another set of flaps both acutely a nd 1 week after flap elevation. The percent survival flap area in grou p A was 69.94, in group B was 89.07, and in group C was 13.00. All the groups are statistically different, with a p value < 0.001. The micro angiograms showed striking differences in the vascular pattern in the cross-flow and the single-pedicle flaps. It is clearly demonstrated th at the arteriovenous cross-flow flaps have increased survival of skin when compared with the conventional axial-pattern flaps.