The role of skin base in perforator-plus flap survival
ZHUANG Jia-zheng, WANG Kai-fang, LIU Min-min, LIN Yi-nan, BAO Wen-zhen, WANG Feng, ZHENG Hai-bo, FANG Fang, ZHUANG Yue-hong
Chinese Journal of Clinical Anatomy ›› 2019, Vol. 37 ›› Issue (1) : 34-39.
The role of skin base in perforator-plus flap survival
Objective To investigate the exact role of a skin pedicle in serving arterial perfusion or venous outflow in flap survival. Methods 40 male SD rats weighing 300g were used in this study and divided into the following 4 groups after harvesting of a flap with a size of 9×3cm on the back: perforator-complete group (perforator preserved in the pedicle), artery-deficit group (ligation of the perforating artery), vein-deficit group (ligation of the perforating vein), and perforator-deficit group（ligation of the perforator）. A laser Doppler flowmeter was used to monitor the flap perfusion after surgery, and the flap necrosis rate was calculated and the vascular diameter at the skin pedicle was measured at day 7. Results The data of the laser Doppler flowmeter indicated a similar perfusion pattern between the perforator-complete group and the vein-deficit group, as well as between the perforator-deficit group and the artery-deficit group. The perfusion in the perforator-complete group and the vein-deficit group was much stronger. The necrosis rate was (26±1) % in the perforator-deficit group, which was not significantly different from the necrosis rate of being (29±1) % in the artery-deficit group, both of which were significantly larger than the necrosis rate being (11±3)% and (12±4)%, respectively, in the perforator-complete group and the vein-deficit group（P<0.001）. The venous network in the skin base was extremely dilated in the skin base in the vein-deficit and perforator-deficit group, whereas the arterial network was modestly dilated in the artery-deficit and perforator-complete group. Conclusion The skin base in the perforator-plus group is more important as an additional route for venous backflow than as an additional arterial input.
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