FLAP PREFABRICATION - EFFECTIVENESS OF DIFFERENT VASCULAR CARRIERS

A new experimental model of a vascular carrier to prefabricate a ''sec ondary'' island flap, the popliteal musculovascular pedicle, was devel oped in the rat. Using quantitative skin-surface fluorometry 30 minute s after sodium fluorescein injection and a flap survival area in the p refabricated 8 x 2.5-cm abdominal composite island flap, we compared t he revascularization ability of our muscular carrier to nonrevasculari zed controls: the skeletonized arteriovenous pedicle and the fasciovas cular pedicle. The free composite graft with no vascular carrier exhib ited near-total necrosis. The skeletonized vascular pedicle demonstrat ed 15.2% +/- 7.8% perfusion of normal skin on dye fluorescence index m easurements and 50% flap survival. The fasciovascular pedicle exhibite d better revascularization, with a dye fluorescence index of 36.2 +/- 15.5 (p < 0.01) and 90% +/- 10% flap survival (p < 0.001). India ink i njection study and histological examination of our model provided visu al evidence of revascularization from the musculovascular pedicle, alo ng with preservation of the carrier's muscular architecture. The muscu lovascular pedicle is a reliable carrier for making new, vascularized composite flaps.