Delayed type IV muscle flap in a feline model

Area of Science:

• Plastic Surgery
• Surgical Innovation
• Muscle Flap Physiology

Background:

• Delayed flaps are established in plastic surgery for skin and musculocutaneous tissues.
• Previous research has explored delaying flaps to enhance perforator inflow.
• The concept of delaying a muscle flap with segmental pedicles remained untested.

Purpose of the Study:

• To evaluate the efficacy of delaying a muscle flap in a model with segmental pedicles.
• To determine if a delayed muscle flap can survive on an inadequate distal blood supply.
• To assess the potential of this technique for reconstructive surgery.

Main Methods:

• A delayed type IV muscle flap model was created using the sartorius muscle in five cats.
• Three sequential operations were performed to establish a single distal pedicle.
• The contralateral leg served as a control group for comparison.

Main Results:

• The delayed muscle flap demonstrated successful perfusion to the proximal tip without necrosis or muscle loss (P < 0.0001).
• Control flaps showed no perfusion beyond the distal portion when supplied by the distal pedicle alone.
• The delayed flap survived on a distal blood supply insufficient for a single-stage procedure.

Conclusions:

• Delaying a muscle flap significantly improves its viability on a distal blood supply.
• This technique expands the arc of rotation, offering solutions for complex reconstructive challenges.
• The delayed muscle flap shows promise for use in the groin, lower abdomen, genitalia, knee, proximal leg, and as a free flap.