The effects of diabetes mellitus (DM) on skin flap tolerance to 3 h of
secondary venous ischaemia were evaluated. Epigastric island flaps we
re elevated 3, 6 and 12 weeks after induction of DM in rats. In the no
n-diabetic control groups, the flap survival was 85% in the 3-week gro
up, 72% in the 6-week, and 78% in the 12-week. In untreated DM groups,
the flap survival significantly decreased to 40% in the 3-week group,
25% in the 6-week, and 17% in the 12-week (P < 0.05 in all groups). F
lap survival in the DM/insulin group decreased to 31% in the 3-week gr
oup. Effects of insulin therapy, however, were observed in later stage
s of DM:71% and 62% survival in the 6- and 12-week group, respectively
. Significant linear correlations between enzymatic responses and the
flap survival were found. The results suggest that DM is detrimental t
o flap tolerance and is associated with the lack of metabolic response
s to secondary ischaemia.