Circulatory and metabolic changes in expanded pig skin flaps

To evaluate circulatory and metabolic changes in pig skin during tissue expansion, the buttock skin of 12 pigs was expanded for 5 weeks. In a second operation, island buttock flaps were elevated bilaterally. Flap temperature, laser Doppler flow (LDF), and fluorescein penetration borders were recorded. Norepinephrine infusions were given twice. After cannulation of the external iliac veins, the total venous outflow from the flaps and metabolic parameters such as glucose and oxygen consumption and lactate production were measured bilaterally. No significant difference in fluorescein staining was found, but laser Doppler flow in the expanded tissue was higher than in nonexpanded skin, whereas the total flap blood flow was not significantly different. A flow reduction was seen in expanded flaps during norepinephrine infusion, whereas nonexpanded flaps showed a slightly increased blood flow. This adrenergic supersensitivity indicates that it is possible that not only surgical nerve section but also tissue expansion can result in sympathetic denervation. No differences in the metabolic parameters were observed.