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Summary
Surgical delay enhances skin flap survival by increasing blood flow, but not through arteriovenous shunting. This study in pigs found no significant change in shunting, suggesting other mechanisms are at play.
Area of Science:
- Plastic Surgery
- Microsurgery
- Vascular Biology
Background:
- Surgical delay is a known technique to improve the survival of axial-pattern skin flaps.
- The precise mechanisms underlying enhanced flap survival following surgical delay are not fully understood.
- Arteriovenous shunting has been hypothesized as a potential contributor to improved flap perfusion.
Purpose of the Study:
- To investigate the changes in blood flow and arteriovenous shunting in axial-pattern skin flaps after surgical delay.
- To determine if alterations in arteriovenous shunting correlate with the enhanced tissue survival observed after surgical delay.
Main Methods:
- Forty axial-pattern skin flaps were created in 10 pigs.
- Radioactively tagged microspheres (50 and 15 µm) were used to quantify blood flow.
- Blood flow and arteriovenous shunting were assessed at 2 and 7 days post-surgical delay.
Main Results:
- A significant increase in blood flow was observed between 2 and 7 days after surgical delay.
- No statistically significant change was found in the index of non-nutrient flow (arteriovenous shunting).
- The percentage of shunting remained unchanged during the study period.
Conclusions:
- Increased blood flow occurs during the delay period, contributing to enhanced flap survival.
- Changes in arteriovenous shunting do not appear to explain the improved tissue survival after surgical delay.
- Further research is needed to elucidate the exact mechanisms responsible for enhanced skin flap survival post-surgical delay.