How Soon does Neovascularization Develop at Island Skin Flaps of Different Size ?

Kim, Hyung Soo; Shin, Young Jin

Abstract

Island flaps or free flaps have been widely used for the management of soft tissue defect in reconstructive surgery. The successful transfer and survival of distal cutaneous flaps depends on the formation of a new nutrient blood supply from the recipient area (neovascularization), independent of the original vascular supply. The neovascularized time differs from size of flap, condition and site of recipient area, and general condition of patient. The author investigated time of neovascularization on island flap and effect of flap size on neovascularization in the rats. One hundred and twenty inferior epigastric island flaps were divided into three groups according to the size of flap (1.5 x 3.0 cm, 3,0x6.0 cm, and 5,0x 6.0 cm). In all group, vascular pedicles were ligated on the 2nd, 3rd, 4th and 5th days after flap elevation. Flap survival was assessed on the 3rd day after pedicle ligation. The results were as follow: 1. In all groups, flap survival was increased significantly in the flaps with pedicle ligation on the 3rd postoperative day compared to those at the 2nd postoperative day. 2. In all groups, flap survival was increased significantly in the flaps with pedicle ligation on the 4th postoperative day compared to those at the 3rd postoperative day. 3. From the 2nd and 3rd postoperative days, the larger flap was elevated, the greater flap survival was increased significantly. 4. Regardless of size of flap, pedicle ligation after 4th postoperative day was complete flap survival, indicating the establishment of adequate neovascularization for flap survival.