Skin flap storage with intracellular and extracellular solutions containing trehalose

To evaluate and compare the effects of IT-Kyoto (IT-K) solution (intracellular type) and ET-Kyoto (ET-K) solution (extracellular type) on long-term skin flap preservation (from 24-120 hours), Japanese white rabbits were used as an animal model and Euro-Collins (EC) solution was used as a comparative solution. A total of 180 animals were divided randomly into 15 groups (N = 12) for 24, 48, 72, 96, and 120 hours of flap storage in three solutions. The survival rate, weight change, and histological appearance of flaps were compared among the three solutions. The survival rates in the IT-K and ET-K solutions were the same: 100%, 100%, 100%, 92%, and 50% in flaps preserved for 24, 48, 72, 96, and 120 hours, which were higher (p < 0.01 in the 72-, 96-, and 120-hour groups) than those in the EC solution group: 100%, 75%, 33%, 8.3%, and 0%. The flap weight gain in the IT-K and ET-K solution groups was less than that in EC solution group (p < 0.01). Histologically, flaps in the IT-K and ET-K solution groups showed a better appearance than those in the EC solution group. It was concluded that in a rabbit model IT-K and ET-K solutions are superior to EC solution for long-term skin flap preservation, and the safe preservation period for IT-K and ET-K solutions is approximately 96 hours. It was also concluded that the effects of intracellular (IT-K)-type solution and extracellular (ET-K)-type solution on rabbit skin flap preservation are similar.