IMPACT OF TISSUE EXPANSION ON FLAP PREFABRICATION - AN EXPERIMENTAL-STUDY IN RABBITS

This study was designed to determine whether tissue expansion after va scular pedicle implantation would increase the survival area of prefab ricated skin flaps. In 20 New Zealand white rabbits, the vascular pedi cle consisting of the central artery and vein of the left ear was impl anted into the neck. At the time of pedicle implantation a subcutaneou s pocket was created measuring 5 x 14 cm beneath the implantation site . Tissue expanders of three different sizes and volumes were implanted in the rabbits of three treatment groups, No tissue expander was impl anted in the animals of the control group. All flaps were transposed a fter 3 weeks to the contralateral ear, and flap survival was assessed 1 week later. The increased area of the flap survival was statisticall y significant in all three treatment groups compared to the nonexpande d flaps (P = 0.003, P = 0.004, P < 0.0001, respectively), In addition there was a statistically significant larger area of survival using a 100-cc expander measuring 5 x 14 cm (the same size as the elevated fla p) compared to 40-cc (3 x 5 cm) or to 60-cc (4 x 8 cm) expanders (P < 0.001, P = 0.004, respectively), The one-way analysis of variance and the t-test were used to show statistical differences. We conclude that the time necessary for neovascularisation of the skin flap could be u sed to expand the tissue, not only increasing the amount of available tissue, but also enhancing the vascularity. (C) 1996 Wiley-Liss, Inc.