COMPARISON OF THE EFFECTS OF ISCHEMIC PRECONDITIONING AND SURGICAL DELAY ON PEDICLED MUSCULOCUTANEOUS FLAP SURVIVAL IN A RAT MODEL

Both surgical delay (SD) and ischemic preconditioning (IP) have been s hown to he effective in improving the survival of pedicled musculocuta neous flaps, The goal of our study was to determine the effects of IP and SD, separately and together, on the survival of pedicled transvers e rectus abdominis musculocutaneous (TRAM) flaps in a rat model, Thirt y-two male Sprague-Dawley rats were divided into four groups of 8 rats each: (1) control, (2) 2-week SD, (3) IP, and (4) SD plus IF. A TRAM flap was elevated in each rat. Flap viability was assessed on the fift h postoperative day by computerized video planimetry, Mean area of fla p survival was compared between the control, IP, SD, and SD plus IP gr oups using analysis of variance and Student's t-test. improvement in s urface area survival was seen in musculocutaneous flaps subjected to I F, SD, and SD plus IP compared with the control, IP and SD improved su rvival 1.3 and 1.4 times the control area respectively. Differences be tween treatment and control flaps were statistically significant (p < 0.04), In addition, the combination of SD plus IP improved survival by 1.8 times, which is statistically different tram controls and from ei ther technique individually (p < 0.002). IP and SD have similar effica cy in improving survival in this musculocutaneous flap model. The effe cts of IP and SD appear to be additive, The advantage of IP over SD is that. IP can be performed during the same operative session as the fl ap elevation and only adds 1 hour to the surgical procedure.