Effects of the number of pedicles on perfusion and survival of venous flaps: an experimental study in rabbits.

Abstract

Venous flaps are new tools for reconstructive surgery; however, the survival mechanisms of these flaps are not clearly known. This study compares the effects of the number of pedicles in venous flaps and studies the perfusion of these flaps. In the rabbit ear composite tissue venous flap model without the underlying bed and perivenous areolar tissue, three groups with a different number of pedicles were created. The groups consisted of single-pedicled, two-pedicled, and three-pedicled venous flaps. Radioactive tracer studies with technetium 99m were undertaken to assess inflow and drainage. The venous pressure in each pedicled vein and pressure gradients were also documented between the venous pedicles. All single-pedicled venous flaps became necrotic. The mean viable flap area was 40.5% for the two-pedicled venous flaps, 75.8% for the three-pedicled flaps, and 94.1% for the axial-pattern control flaps. Inflow and drainage of the radioactive substance in the three-pedicled venous flaps were better than the two-pedicled venous flaps, but the axial-pattern control flaps were superior to both. We conclude that although venous flaps are still not as reliable as conventional flaps, increasing the number of pedicles affected flap survival positively, and venous flap perfusion occurred due to pressure gradients between flap pedicles.