Temporal fascial periosteal and musculoperiosteal flaps in the pig: design and blood flow assessment.

Abstract

The availability of a vascularized periosteal flap with bone-forming potential could greatly enhance the reconstructive capabilities of the craniofacial surgeon. Previous observations seem to indicate that the bone-forming potential of periosteal flaps depends on the vascularity of the flap. The purpose of the present experiment was to design temporal fascial periosteal and musculoperiosteal flaps in the pig and to compare the periosteal blood flow with unoperated periosteum in the same location. The radioactive microsphere (15-micron diameter) technique was used to measure periosteal capillary blood flow in periosteal flaps and unoperated control, randomized to each side of the head in nine pigs (Yorkshire; weight, 12-14 kg). The periosteum was (1) raised based on the temporalis muscle with vascular supply from the deep temporal vessels (n = 6), (2) raised based on temporoparietal fascia-deep temporal fascia with blood supply from the superficial temporal vessels (n = 6), or (3) left intact (n = 6). The mean periosteal capillary blood flow rates in the intact periosteum (0.107 +/- 0.001 ml/min/g), the temporal musculoperiosteal flaps (0.081 +/- 0.01 ml/min/g), and temporal fascial periosteal flaps (0.087 +/- 0.012 ml/min/g) were not significantly different. These observations indicate that the blood flows for both musculoperiosteal and fascial periosteal flaps were comparable to control intact temporal periosteum.