Prefabrication of skin flaps using vein grafts: an experimental study in rabbits

Prefabrication provides a new method for creating donor sites which are not limited by natural vascular territories. There are several methods for prefabrication, and these include implantation of greater omentum, blood vessels or muscle flaps. Based on the concept that an arterio-venous (A-V) shunt results in sufficient neovascularisation to support a free flap, we used a rabbit model to investigate the characteristics of these flaps. Prefabrication of an abdominal wall donor site was performed using the left epigastric vein in 20 male New Zealand white rabbits. An 8 x 10 cm skin flap was elevated 10 days after prefabrication, either as an island or a free flap. Survival of the skin flaps exceeded 93% and was independent of position of the vascular pedicle, direction of blood flow, or nature of the flap (island or free flap). Angiograms showed a very rich neovascularisation within the prefabricated flap.