A new surgical delay technique on the extended dorsal island skin flap model in the rats

Introduction: Complicated wounds which can be cured hardly, have resistance to care, are an important resource for a health expense. Reconstruction by the flap is an important option to cure for these kinds of wounds. There are a lot of studies in literature about increasing flap viability. For this purpose, a lot of surgical preconditioning technique was developed. But in extended dorsal island flap model on rats our surgical delay technique which firstly flaps harvested on double perforators and then degrade to single perforator, has not seen in literature. In this study, in order to determine the rate of flap necrosis of the rats which were applied and not applied surgical delay technique and to prove a hypothesis that flap viability increases by this new delay technique.Materials and Methods: 23 adult Sprague ? Dawley male rats were used in this study. Their weights were between 190 and 350 gr. The control group which consists of 10 rats. Experimental group which consists of 13 rats. Using flap model was an extended dorsal island skin flap model. The rats which are in control group, only the left deep circumflex iliac artery was identified and kept. Percentage of necrotic areas of the flaps were recorded 7 days after the operation. The rats which are in the experimental group, the left deep circumflex iliac artery and the left lateral thoracic artery were identified and kept. In this way we prepared a flap which consisit double perforator. After than we eliminated the left lateral thoracic artery. The flap was transformed into a single perforator flap model which was fed on left deep circumflex iliac artery by second operation that was done 7 days after. Percentage of necrotic areas of the flaps were recorded 14 days after from the first operation.Results: The average of determined necrosis of the rats in the control group was observed as 5,4 cm2 (7,6 %) in the 7th day. The average of determined necrosis of the rats in the experimental group was observed as 0,17 cm2 (0,22 %) in the 14th day. The difference of between two groups was meaningful statistically (p=0,000).We determined that necrosis was located only on the right upper corner of the flap instead of on all of the flap distals.Conclusion: According to our study, flap viability increases by applying this new delay technique to flaps.The reason for the occurrence of flap necrosis on the right upper corner of the flaps can be explained by ?the central ven?, which located between two lateral thoracic artery angiosoms and behaves as a ?intermediate? angiosom. Central ven was described by Acartürk et al. in 2009.