Survival of Myocutaneous Flaps: Experimental Evaluation by Intra-arterial Injection of a Dye

Abstract

\s=b\ Ninety-four myocutaneous island flaps of the pectoralis major were studied in the rabbit using sulfan blue (Disulphine\x=req-\ blue). In 13 cases, the dye was injected intra-arterially in the acromiothoracic artery before the flap was lifted, and 47 more were injected after the lifting of the flap. In 34 further cases, sulfan blue was injected intravenously once the flap had been lifted. In another 16 flaps, vascularization was studied by means of "diaphanization" (ie, making the tissue transparent or diaphenous in nature). In all groups, the surviving length of flap was observed to be greater than the stained length. Intra-arterial administration of sulfan blue was associated with reduced flap survival. Viable flap length was not related to the anatomy of the vascular base. (Arch Otolaryngol 1985;111:43-46) The viability of a myocutaneous flap depends on preserving its vascularity. Because of this, it is con¬ venient to evaluate the condition of the vascular bed at the time of sur¬ gery. One of the most practical meth¬ ods is the use of dyes, such as fluorescein and sulfan blue (Disulphineblue), injected intravenously (IV) into the vascular system. The reliability of these methods, however, is controver¬ sial because some authors have found a good correlation between the exten¬ sion of the colored and surviving areas14 while others have concluded that the surviving area is substantial¬ ly greater than the dye-stained area.5Sulfan blue was the dye used in this study. One advantage of using sulfan blue is that, unlike fluorescein, it does not require UV light for its évalua-