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Island rat groin flaps with twisted pedicles.
M Erol Demirseren1, M Oguz Yenidunya, Sibel Yenidunya
1Departments of Plastic and Reconstructive Surgery and Pathology, Fatih University School of Medicine, Ankara, Turkey. medemirseren@yahoo.com
Plastic and Reconstructive Surgery
|October 1, 2004
Summary
Pedicle twisting in rat groin flaps showed that less than 360 degrees of rotation did not affect flap survival. Twisting of 720 degrees always caused necrosis, while 360 degrees caused changes but not necrosis.
Area of Science:
- Plastic Surgery
- Microsurgery
- Experimental Surgery
Background:
- Clinical practice often avoids pedicle rotation and twisting in flap surgery due to concerns about compromised perfusion.
- The effects of pedicle torsion in island flap models are not well-established experimentally.
Purpose of the Study:
- To investigate the impact of varying degrees of pedicle twisting on island rat groin flap survival and perfusion.
- To determine the threshold of pedicle torsion that leads to flap compromise or necrosis.
Main Methods:
- Forty male Wistar rats underwent bilateral groin flap elevation.
- Flaps were subjected to pedicle rotations of 0 (control), 180, 270, 360, or 720 degrees.
- Blood flow was assessed using laser Doppler flowmetry; edema and necrosis were evaluated 10 days postoperatively.
Main Results:
- Rotations of 180 and 270 degrees showed no significant difference compared to controls.
- Flaps with 360-degree rotation exhibited edema and congestion but survived, with altered flap weights.
- All flaps subjected to 720 degrees of rotation underwent complete ischemic necrosis.
Conclusions:
- Pedicle twisting of less than 360 degrees does not compromise rat island flap survival.
- A 720-degree pedicle twist invariably results in skin flap necrosis.
- A 360-degree pedicle twist, while causing some edema and congestion, does not lead to flap necrosis in this model, though it impacts flap weight.