USE OF FREE INTERPOSITIONAL VEIN GRAFTS AS PEDICLES FOR PREFABRICATION OF SKIN FLAPS

Pedicles created from a long vein graft increase the scope and applica tions of prefabricated skin flaps. This study reports the survival and pattern of neovascularization of lower abdominal skin flaps in rabbit s based on a pedicle formed by interposition of a long vein graft betw een the divided ipsilateral femoral artery and vein. Flaps were elevat ed 2-5 weeks after pedicle implantation and the surviving area quantit ated and vascular patterns examined 1 week later. Only 8 out of 35 fla ps were greater than 50% alive, the most frequent cause of flap failur e being pedicle non-patency. If the pedicle remained patent, complete flap survival was possible as early as 2 weeks after implantation. In non-patent pedicles, recanalization or formation of a new vascular net work may, given at least 4 weeks, be sufficient to ensure partial flap survival. The findings indicate that implantation of a long, skeleton ized vein graft is an unreliable method of prefabrication of abdominal skin flaps in this model. (C) 1994 Wiley-Liss, Inc.