THE REVASCULARIZATION INTERFACE IN FLAP PREFABRICATION - A QUANTITATIVE AND MORPHOLOGIC STUDY OF THE RELATIONSHIP BETWEEN CARRIER SIZE AND SURVIVING AREA

To make a quantitative assessment of the relationship between size of vascular carrier and surviving area in a prefabricated flap, vascular carriers composed of the superficial epigastric arteriovenous bundles and a surrounding fascial patch with varying sizes were transferred un der a 7- x 7-cm bipedicled abdominal skin flap in a rat model. Seven d ays later, the abdominal flaps were raised as composite island flaps c onnected only by the superficial epigastric vascular pedicle, transfer red, and then sutured back into place. Immediately after replacement, the degree of revascularization was assessed using quantitative skin f luorometry, after intravenous injection of sodium fluorescein. At 7 da ys after elevation as an island flap, the area of skin flap surviving was recorded and plotted on a map depicting the original flap surface. High levels of fluorescence appeared on the flap surface where the ca rrier was tacked underneath. The prefabricated island flaps survived w ith a circular shape up to approximately 4 times the radius of the vas cular carrier. When the distance was converted into area, theoreticall y an area 13 times the area of the vascular carrier survived, regardle ss of its size in this experimental model. Histologic examination reve aled connections of fine capillaries between the carrier and flap.