THE MYOADIPOSE FLAP - A NEW COMPOSITE

A prefabricated composite fat flap consisting of muscle woven into all anatomically distinct fat pad was studied in a rabbit model. In 17 ra bbits, a 2-cm strip of latissimus dorsi was woven ir-ito the parascapu lar fat pad on one side, with the contralateral fat pad serving as a c ontrol. At 3 weeks, the endogenous blood supply of both the control an d the experimental fat pads was isolated and ligated, and the composit e fat/muscle flap was transferred to the chest wall. At 6 weeks, anima ls were killed, and flaps were analyzed for length, width, and weight; perfused with fluorescein or lead oxide; and examined histologically. Significant differences were found between the control and experiment al fat pads with regard to weight and length. Experimental flaps were found to be perfused fully with fluorescein and lead oxide; control fa t pads were found not to be perfused. TF-le lead oxide group revealed extensive growth of blood vessels from the latissimus graft into the e xperimental fat pad. No vessels were visualized in the controls. Final ly, sections of the control and experimental flaps were analyzed histo logically. A preponderance of viable fat, with evidence of neovascular ization, was found in experimental flaps, compared with the necrotic f at that characterized the controls. We conclude that prefabrication of a fat flap is possible and may have extensive application in various areas of plastic surgery.