Influence of Recipient-Bed Isolation on Survival Rates of Skin-Flap Transfer in Rats

Abstract

The effect of recipient-bed isolation with artificial barriers on skin-flap survival, compared to flap transfer without bed isolation, was evaluated in a modified rat epigastric skin-flap model. The pattern of blood flow in the raised flap with a proximal axial portion and distal random portion was confirmed by laser Doppler flowmetry. Forty rats were divided into four groups. Three of the groups had one of three different artificial barriers-silicone, polypropylene, or gelatin sponge. In each of these three groups, one of the artificial barriers was placed between the flap and its recipient bed after flap replacement. The flaps without bed isolation (Group 4) were used as controls. The survival area was measured 7 days postoperatively. Results demonstrated that necrosis in the groups with silicone and polypropylene barriers was significantly higher than in the controls. Histologically, neovascularization was shown in the flaps without artificial barriers. Foreign-body reactions were observed in the flaps with bed isolation and among these, severe inflammation and congestion were seen in the flaps with polypropylene isolation. In this study, the authors demonstrated that the random portion of a rat skin flap could survive partially through imbibition of plasma and the ingrowth of new vessels from the recipient bed. This neovascularization can be prevented by recipient-bed isolation with an artificial barrier. Bed isolation with a silicone sheet is suggested for use in the study of rat skin-flap survival.

Improvement of a long random skin flap survival by application of vascular endothelial growth factor in various ways of local administration in a rat model

“…In studies where bed isolation from an overlying flap with artificial sheets was examined, it has been shown that the survival rates of the flaps were significantly reduced compared to the flap survival rates in cases where flaps were transposed directly over the recipient bed. [28,29] The theory of revascularisation of the flap by the tissue of the recipient site either by inosculation or by connection of the vessels may be also supported.…”

Controlled delivery of bFGF to recipient bed enhances the vascularization and viability of an ischemic skin flap

“…In other studies utilizing artificial barrier sheets, separation of the skin flap and the recipient bed caused worsening of flap necrosis. 29,30 These studies suggested a supportive role of the recipient bed as a supplying blood. Indeed, in our previous study, 6 gene transfer of bFGF to the recipient bed induced vessel formation from the recipient bed to the ischemic flap, and significantly improved blood perfusion of the flap.…”

Sustained (rh)VEGF165 release from a sprayed fibrin biomatrix induces angiogenesis, up‐regulation of endogenous VEGF‐R2, and reduces ischemic flap necrosis

“…FS also closely approximated and maintained the flap in the recipient bed. A study by Jones et al 27 demonstrated that separating the flap and the recipient site with an impermeable polypropylene sheet resulted in impaired flap healing. This suggests that the nonblocking porous structure of the FS increased flap adherence and decreased flap necrosis.…”