Demonstration of circulation haemodynamics in random pattern thinned skin flap (an experimental study)

Area of Science:

• Plastic surgery
• Wound healing
• Surgical techniques

Background:

• Clinical applications of thin skin flaps are established, but their hemodynamic circulation remains debated.
• Understanding flap survival mechanisms is crucial for optimizing surgical outcomes.

Purpose of the Study:

• To investigate the survival and circulation hemodynamics of random pattern thinned skin flaps in a porcine model.
• To compare the efficacy of standard flaps, thinned flaps, and thinned flaps with silicone sheeting.

Main Methods:

• Three groups of random pattern skin flaps were created in pigs: standard, thinned, and thinned with silicone sheeting.
• Flap sizes included 5x5 cm and 5x10 cm.
• Survival rates were assessed, and microangiography and technetium-99m-labeled microspheres uptake were used to evaluate vascularity.

Main Results:

• Mean survival for 5x10 cm flaps was 95.5% (standard), 64.9% (thinned), and 33.67% (thinned with silicone).
• Survival for 5x5 cm flaps was 100% (standard), 100% (thinned), and 68.2% (thinned with silicone).
• Microangiography showed reduced and thinner subdermal vascular plexuses in thinned flaps, especially distally. Silicone sheeting induced proximal dilatation.

Conclusions:

• The subdermal vascular plexus plays a significant role in the survival of random pattern thinned skin flaps.
• Flap bed osmosis and plasma imbibition are key supporting mechanisms for thinned flap survival.