Murine skin flap survival may not be affected by underlying fat viability

One problem in the treatment of degloving injuries is the accurate prediction of the survivability of the avulsed tissue. Initial evaluation frequently underestimates the degree of eventual flap loss, and in many cases, there is a progressive necrosis that continues over the ensuing days. The pathophysiology of this phenomenon is unclear. We undertook this study to test the theory that underlying devascularised fat contributes to overlying skin necrosis. A dorsal random skin flap model was used in the rat. Sixty-six rats were divided into three groups: flaps with viable fat and silicone sheeting underneath, flaps with devascularised fat and silicone sheeting underneath and control flaps with only silicone sheeting underneath. Flap necrosis (% area+/-SEM) was evaluated at one week, and found to be 27.1+/-4% in the live fat group, 33.2+/-4% in the dead fat group and 33.6+/-5% in the control group. One-way analysis of variance showed no statistically significant difference between the three groups at a power of 80%. In this study, we have shown that neither live nor dead fat has a significant influence on the survival of an overlying random skin flap in the rat.