Assessment of delay in bilateral thoracoabdominal island flaps in the rat

This study demonstrates improved perfusion and viability following surgical delay in a bilateral paired flap model that minimizes the effects of systemic variables in the rat. Surgical delay was achieved in one of two paired thoracoabdominal island flaps by ligating and cutting the inferior epigastric (distal) pedicle three days before flap construction. This created a hypoperfused zone. Within three days of delay, perfusion of the delayed region, as documented by quantification of tissue fluorescein delivery, increased markedly and often exceeded nondelayed values. Construction of 2 X 11-cm island flaps based on the superior epigastric pedicle at this time was associated with an average of 1.1-cm necrosis, compared with 2.6 cm in nondelayed flaps.