Prefabricated flap composed by skin and terminal gastromental vessels. Experimental study in rabbits

The angiogenic induction property of the omentum makes it a promising pedicle for prefabricating flaps. Therefore, the objective of this paper is to establish the abdominal area to be prefabricated by the omental pedicle and to analyse the prefabricated potential (PP) according to the time delay between the pedicle introduction and the flap release.

Forty-four rabbits were divided into four groups (A, B, C and D). In group A, a piece of skin, subcutaneous tissue and abdominal cutaneous muscle was fully released and sutured again in place. In the other groups, a 9-cm2 omental pedicle containing the gastromental vessels distally tied was transposed and sutured to abdominal cutaneous muscle. A second procedure, consisting of incision and release of the flap that contained skin, subcutaneous and cutaneous abdominal muscle pediculated only by the omentum, was carried out. The only variation was the time delay between the two procedures: 7, 21 and 56 days for groups B, C and D, respectively. The flaps were inspected 15 days after the last procedure. The pieces of viable area were immunostained using anti-CD31 for estimation of the microvascular density.

The mean and maximum viable areas in group D were 45.29 and 99.37cm2, respectively (average PP=5.03 and maximum PP=11.04). There was no significant difference between the viable areas in groups C and D. The mean microvascular densities of groups B, C and D were 24.54, 33.20 and 27.03 vessels/mm2, respectively.

The omental tissue has great potential for prefabrication of flaps, and the delay time for the second procedure should be at least 21 days.