Proposed new method for angiographically quantifying neovascularization in prefabricated flaps

Prefabricated flaps have many potential applications in plastic and reconstructive surgery. Despite numerous experimental investigations and clinical applications, a standard quantification procedure for analyzing neovascularization in prefabricated flaps has not yet been established in the literature. In this study, we developed a new method for quantifying neovascularization, using a standard integral line plate including 25 evenly spaced lines corresponding to a 15-cm flap length, which was subsequently analyzed under a 2x magnification loupe. Vessel quantity was determined by counting the total number of times that vessels perfused by Micropaque intersected the integral lines over the entire surface of the flap. This new method was used for quantifying neovascularization in 156 prefabricated flaps, and we concluded that this technique is very simple and useful, allowing precise determination of the amount of neovascularization in prefabricated flaps on angiograms. Based on this principle, the quantification of neovascularization in any size of prefabricated flap can be easily performed using suitably modified integral line plates corresponding to the various flap dimensions.