Side Of Flap Research Articles

Verification and measurement of the side-cut angle of corneal flap in patients undergoing LASIK surgery using FS 200 kHz femtosecond laser system versus conventional mechanical microkeratome.

Introduction: This is a prospective nonrandomized interventional clinical trial conducted to measure and verify the intended versus the achieved LASIK flap side-cut angle in two groups of patients, Femtosecond laser-assisted in-situ keratomileusis (FS-LASIK) using Wavelight FS200 (Alcon Laboratories Inc. Fort Worth, TX, USA) and the conventional mechanical microkeratme (Moria M2 90).Methods: This prospective clinical trial was conducted on 40 eyes of 20 patients (20 eyes in each group) in the interval between December 2017 and August 2018. Heidelberg anterior segment OCT was done for the patients 2 weeks postoperatively to measure the corneal flap side cut angle.Results: The achieved side-cut angles of all the patients in the first group (the femtosecond laser-assisted in-situ keratomileusis group) were equal to or more inverted than the intended angle (110–115°) in all the study candidates with a minimum angle (110°) and maximum angle (155°). Unlike the achieved side-cut angle in the second group (the mechanical microkeratome group) in which all the achieved side-cut angle were acute with a minimum angle (30°) and maximum angle (65°) which is more acute than the intended side-cut angle (70°).Conclusion: In our study we found that the femtoLASIK technology was capable of making the flap side-cut angle more obtuse than the intended angle, unlike the achieved flap side-cut angle done using the mechanical microkeratome which was more acute than the intended angle in 100% of cases.

Application of modified keystone flap in repairing of skin and soft tissue defect around joint

To explore the effectiveness of keystone flap in repairing skin and soft tissue defects around joint. Between March 2013 and December 2017, 10 patients of skin and soft tissue defects around the joint were repaired with keystone flaps. There were 6 males and 4 females. The age ranged from 17 to 72 years, with an average age of 57.5 years. The skin and soft tissue defects located around the joints, including 2 cases of hip joints, 4 cases of knee joints, 3 cases of elbow joints, and 1 case of wrist joint. The cause of skin and soft tissue defects included scar contracture in 3 cases, basal cell carcinoma in 3 cases, squamous-cell carcinoma in 3 cases, and dermatofibrosarcoma protuberant in 1 case. The area of defects ranged from 4 cm×3 cm to 11 cm×11 cm. The keystone flap was designed beside the wound, and the V-shaped flap was designed at the longer side of the fan-shaped flap. The area of flap ranged from 7 cm×3 cm to 35 cm×10 cm. The flap was constantly compressed by vacuum assisted closure after operation for 3-6 days. Primary wound healing was achieved and the flaps survived. All patients were followed up 6-24 months (mean, 15 months). The texture and color of flap was similar to the adjacent area. The appearance and function of joint were satisfactory. The keystone flap is a feasible and efficient way to repair the wound around joint. Furthermore, the skin color and texture is similar to the surrounding tissue after healing.

Increasing the Aerodynamic Performance of a Formula Student Race Car by Means of Active Flow Control

<div class="section abstract"><div class="htmlview paragraph">This article involves an experimental study regarding the capability of fluidic actuators to increase the aerodynamic performance of a four-element race car rear wing. Sweeping jet actuators are integrated in the upper flap, of which the angle of attack is increased by up to Δ<i>α</i><sub>F3</sub> = 40<sup>°</sup> with reference to a passively optimized setup. Different velocities of the emitted sweeping jets are applied to study the influence of momentum coefficients <i>c<sub>μ</sub></i> = 0.04 … 0.98%. To prove the feasibility of the approach, flow control is first applied to a stand-alone rear wing tested in a small wind tunnel. Subsequently, a realistic race car model featuring the controlled rear wing is investigated in a larger-scale wind tunnel. Employing particle image velocimetry, flow visualization techniques as well as pressure and force measurements, we show that the velocity field on the suction side of the upper flap is characterized by flow separation of different degrees when the angle of attack is increased beyond Δ<i>α</i><sub>F3</sub> = 20<sup>°</sup> (rear wing only) and Δ<i>α</i><sub>F3</sub> = 30<sup>°</sup> (complete race car). Generally, the employed fluidic devices have a positive impact in terms of the aerodynamic performance for all investigated angles of attack as overall downforce increases by up to 22 % are achieved, however accompanied by larger drag. Nonetheless, an in-house simulation indicates a potential lap time reduction of 0.17 % at the Formula Student endurance race circuit at Hockenheim under permanent actuation. Even greater gains are to be expected for a selective employment during cornering only or for skidpad and acceleration competitions.</div></div>

Three-dimensional numerical study on aerodynamics of non-flapping bird flight

Numerical investigations have been carried out to study aerodynamics of non-flapping characteristics of bird flight. Commercial software ANSYS Fluent 16.1 has been used for three-dimensional computations by considering four types of wing models. At first, square prisms with built-in side flaps are considered and the effects of Reynolds number (Re), angle of attack and dihedral angle on flow characteristics have been investigated. Thereafter, flow past actual bird wing has been considered for wings of owl, seagull, teal and bat. Role of shear layer formation at mid-span of wings has been illustrated with the help of streamline plots for different values of Re. In addition, pulsating flow is imposed on inlet velocity and the responses are obtained in form of force coefficients, phase portraits, time-dependent signals and their spectra.

Description of Bursaphelenchus irokophilus n. sp. (Nematoda: Aphelenchoididae) isolated from Milicia excelsa (Welw.) C.C. Berg wood imported into Italy from Cameroon

Summary A new species of Bursaphelenchus, extracted from unprocessed logs of Milicia excelsa from Cameroon and arriving in the port of Leghorn, Tuscany, Central Italy, is described. Bursaphelenchus irokophilus n. sp. is based upon morphological and molecular characters and is characterised by the two-lined lateral field, mitten-shaped spicule possessing cucullus and well-developed and slightly dorsally curved condylus with narrowly rounded tip, female vulva with side flap, and long, smoothly tapering and strongly ventrally recurved female tail. The new species belongs to the abietinus-group and is similar to, but distinguished from, B. abietinus and B. rainulfi by the position of secretory-excretory pore, longer and slender female tail and some morphometric values. In addition, the phylogeny based on SSU and D2-D3 LSU regions shows that this species belongs to the abietinus-group, the relationship among the species of this group being discussed.

Therapeutic effect of endoscopic anterior fundoplication by MUSE™ in thirteen patients with gastroesophageal reflux disease

Objective To evaluate the efficacy and safety of endoscopic anterior fundoplication by the MUSE™ endoscopic stapling device in gastroesophageal reflux disease (GERD). Methods From March to November 2017, in the Department of Gastroenterology of Chinese PLA General Hospital in Beijing, The First People′s Hospital Affiliated to Shanghai Jiao Tong University and Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, thirteen GERD patients who underwent the endoscopic anterior fundoplication by the MUSE™ system were enrolled. The GERD health related quality of life questionnaire (GERD-HRQL) score, satisfaction of symptomatic control, questionnaire for gastroesophageal reflux disease (GERD-Q) score, the degree of esophagitis, condition of gastroesophageal flap valve, medicine administration and side effects were compared before and after the operation. Paired t test and Wilcoxon rank sum test were performed for statistical analysis. Results The total GERD-HRQL score decreased from 23 points (14 to 36 points) before operation when proton pump inhibitor (PPI) was stopped for seven days to 3 points (0 to 21 points) at three months after operation and 1 point (0 to 18 points) at six months after operation; and the differences were statistically significant (Z=-3.111 and -3.183, both P 0.05). The number of patients without esophagitis increased from three before treatment to eight after treatment. Additionally, the number of patients whose gastroesophageal flap valve was less than grade Ⅱ increased from three before operation to 11 at six months after operation. The patients were followed up for six months, among 13 patients, 10 patients were completely deprived of PPI, one patient was reduced over 50%, and two patients were treated with less than 50% reduction. All 13 patients had mild tolerable abdominal pain and sore throat within 48 hours after operation. No other adverse reactions were observed. Conclusion The endoscopic anterior fundoplication by the MUSE™ is a safe and effective treatment for GERD. Key words: Gastroesophageal reflux; Fundoplication; Proton pump inhibitors; Medigus ultrasonic surgical endostapler

Clinical efficacy of anti-migration features in fully covered metallic stents for anastomotic biliary strictures after liver transplantation: comparison of conventional and anti-migration stents

Anastomotic biliary strictures (ABSs) are one of the most frequent adverse events that occur after orthotopic liver transplantation (OLT). Multiple plastic stents (MPS) have been validated for this indication. More recently, fully covered self-expandable metallic stents (FCSEMSs) have been used with positive outcomes, but also have a higher rate of migration, which may limit success. Our primary objective was to compare stent migration rates observed with standard FCSEMSs (Std-FCSEMSs) and so-called anti-migration FCSEMSs (Am-FCSEMSs), which are newly designed with reversed proximal side flaps. Secondary objectives were to compare rates of stricture resolution and procedure-related morbidity. We conducted a retrospective analysis of a subset of patients (FCSEMSs for post-OLT ABS) from 2 prospectively maintained databases of (1) OLT patients, and (2) ERCP and stent placement. Between January 2009 and January 2016, consecutive patients presenting with ABS after OLT referred to Cochin Hospital (Paris, France) for ERCP and receiving a FCSEMS were included. Exclusion criteria were any other cause of biliary stricture (ie, malignant stricture, ischemic origin), and biliary fistulae. One hundred twenty-five FCSEMSs (57 Am-FCSEMSs, 52 type 1 Std-FCSEMSs, and 16 type 2 Std-FCSEMSs) were used in 75 patients for ABS after OLT, with a planned stent placement period of 6 months in all patients. Patient characteristics and rates of previous endoscopic treatment or timing of ABS occurrence after OLT were not different between the groups. The rate of FCSEMS complete migration was 16% (20/125), consisting of 1.7% (1/57) for Am-FCSEMSs and 28% (19/68) for type 1 and 2 Std-FCSEMSs (P< .0001). All attempted stent removals (100% of patients) were successful. First follow-up ERCP after each FCSEMS highlighted a stricture resolution rate of 78.4% (98/125), including 93% (53/57) for Am-FCSEMSs and 66.2% (45/68) for type 1 and 2 Std-FCSEMSs (P< .001). After a median follow-up of 28 months after stent removal (range, 12-66 months), stricture recurrence was observed in 12.3% (range, 11%-17%) of patients treated with Am-FCSEMSs against 55.9% (range, 54%-56%) of those receiving Std-FCSEMSs (P< .0001). In patients with ABS after OLT, the use of Am-FCSEMSs significantly decreased the risk of stent migration, improved stricture resolution at the time of stent removal, and reduced the rate of stricture recurrence during follow-up. Endoscopic removal success and procedure-related morbidity were similar for both standard and anti-migration stents.

Application of lower leg perforator flap for repair of the soft tissue defects in the donor site of toe transplantation

Objective To explore the clinical effects of lower leg perforator flap in the treatment of the soft tissue defects in the donor site of toe transplantation. Methods From December 2015 to December 2016, 15 cases of thumb or finger defects were reconstructed by the transplantation of big toe nail flap, the fibula side flap of great toe and second toe wrap-around flap. Simultaneously, the free peroneal artery perforator flap or posterior tibial artery perforator flap was used to repair the soft tissue defects in donor site of toe transplantation. Results All the reconstructed fingers and thumbs survived. All the flaps used to cover donor site of the foot survived. The follow-up time ranged from 1 to 18 months with an average of 8.6 months. The donor site of toe transplantation recovered well without influence on wearing shoes and walking. According to the Maryland foot function scoring system issued by Sanders et al, the results were rated as excellent in 14 cases and good in 1 case. Conclusion Lower leg perforator flap for repair of the soft tissue defects in the donor site of toe transplantation can not only reconstruct the good appearance and function of thumbs and fingers, but also can restore the integrity of donor foot. The function and appearance of the foot are well recovered. Key words: Surgical flaps; Treatment outcome; Soft tissue defects; Toe donor site

Shoulder-related donor site morbidity and patient-reported satisfaction after delayed breast reconstruction with pedicled flaps from the back: A comparative analysis

We report a study evaluating and comparing shoulder-related morbidity associated with delayed breast reconstruction using either the conventional latissimus dorsi (LD) flap or the thoracodorsal artery perforator (TAP) flap. We conducted a retrospective cohort study of women over 18 years of age who had a unilateral, delayed breast reconstruction by either an LD or TAP flap at one center over a 56-month period. Shoulder function was assessed using the Constant Shoulder Score (CSS), which evaluated pain, activity of daily life (ADL), range of motion (ROM), and strength. A number of secondary outcomes were also examined. Forty-nine women were included. Demographic and breast treatment data were comparable between the groups. The mean total CSS score for the reconstructed side of the TAP flap was statistically significantly better than that of the LD flap, with a difference of 10.9 points (95% confidence interval [CI] = 2.6-19.2, p-value 0.01). The mean total CSS score for the nonreconstructed side was not statistically significant between groups, with a difference of 0.1 points (95% CI = -6.1-6.2, p-value 0.98). The subscore analysis revealed that women reconstructed using the TAP flap had a difference of 3.2 points for pain (p-value 0.003) and 5.5 points for ROM (p-value 0.011). The factors ADL and strength were of equal magnitude in both groups. Patients who undergo delayed breast reconstruction by the TAP flap seem less prone to suffer from postoperative pain and restricted ROM, thereby suggesting that this flap should be considered an advantageous alternative to the conventional LD flap. A randomized clinical trial is warranted to provide sufficient evidence to this statement.

A comparative evaluation of maxillary canine retraction using flap and flapless corticotomy: A clinical study

Objective: The objective of this study is to compare and evaluate the effectiveness of maxillary canine retraction using flap and flapless corticotomy. Materials and Methods: A sample of 10 adult patients undergoing orthodontic treatment requiring therapeutic extraction of maxillary first premolars bilaterally were selected, compliant with the inclusion criteria. By random allocation, one site was selected for flap corticotomy-facilitated orthodontics (CFO) and opposite site for flapless CFO. After corticotomy procedure, maxillary canine retractions were done on both the sides using sliding mechanics. A paired t-test was used to determine the statistical significance of the difference in the amount of tooth movement between the flap and flapless sides. Results: There were statistically significant differences (P ≤ 0.01) in the rates of anteroposterior movement of the canines between the flap and flapless sides at all measurement times, and the rates of canine retraction were consistently higher in the flap side than in the flapless side. Conclusions: Flap corticotomy technique is more effective as compared to that of flapless corticotomy technique. Clinical Relevance: Flap corticotomy will be more effective clinically; however, the histologic correlation in regard to the changes in both the technique would be more beneficial.

A novel surgical method for total nail ablation: Use of triple flap technique

&lt;p&gt;Total nail ablation for the treatment of onychodystrophies can be performed by using chemicals, surgical resection or laser ablation of nail matrix.&lt;strong&gt; &lt;/strong&gt;A female patient with bilateral severe onychodystrophy as a result of inadvertent previous nail surgeries was treated surgically. Proximal complete nail matrix resection and distal 10 mm wide transverse strip partial nail bed resection were performed. A 5 mm wide transverse strip of nail bed was left intact proximally. Proximal nail matrix defect was closed by using the skin of proximal nail fold. The distal nail bed defect was reconstructed by using triple flap technique which was composed of a main central advancement flap containing ventral toe skin and two side flaps containing nail fold skin. The patient healed without any problem and her nail problem was treated successfully. The cosmetic appearance of her first toes was acceptable. Surgical nail ablation followed by volar skin coverage of dorsal surface of the distal phalanx bone by using triple flap technique is an effective surgical treatment method for the correction of advanced nail plate deformities requiring total nail ablation. &lt;/p&gt;

Delayed compression of the common peroneal nerve following rotational lateral gastrocnemius flap: case report

The authors present a case of delayed peroneal neuropathy following a lateral gastrocnemius rotational flap reconstruction. The patient presented 1.5 years after surgery with a new partial foot drop, which progressed over 3 years. At operation, a fascial band on the deep side of the gastrocnemius flap was compressing the common peroneal nerve proximal to the fibular head, correlating with preoperative imaging. Release of this fascial band and selective muscle resection led to immediate improvement in symptoms postoperatively.

Changes in the length over time to the triangular flap in the Cronin method

ObjectiveIn initial cheiloplasty, inserting a triangular flap into the lower third of the upper lip is effective in reliably pulling down the cleft in Cupid’s bow. Measuring the length and designing the triangular flap are easier with the Cronin method than with other surgical techniques, and this method may be seen as a technique with which relatively stable results can be obtained with less dependence on the skill and experience of the surgeon. As the patient grows, however, the prepared flap increases in size. This study measured the shape of the triangular flap prepared with the Cronin method and separately investigated changes in size over time. MethodsThe subjects were 65 patients who underwent initial surgery for unilateral cleft lip using the Cronin method. The length of each side of the triangular flap was measured on the most recent outpatient visit, and changes in the length of each side over time were investigated separately in males and females. The ratio of the triangular flap to the total length of the philtrum was also investigated. ResultsIncreases on all sides of the triangular flap were seen over time, with the length approximately doubling by the period of adolescence. The increase was not only in the vertical direction, but also in the horizontal direction, so that the flap occupied approximately 40% of the skin of the upper lip. ConclusionThe triangular flap stretches with growth, and becomes conspicuous in some patients as a scar.

Modified Fisher method for unilateral cleft lip-report of cases

BackgroundRehabilitation of normal function and form is essential in cleft lip repair. In 2005, Dr. David M. Fisher introduced an innovative method, named “an anatomical subunit approximation technique” in unilateral cleft lip repair. According to this method, circumferential incision along the columella on cleft side of the medial flap is continued to the planned top of the Cupid’s bow in straight manner, which runs parallel to the unaffected philtral ridge. Usually, small inlet incision is needed to lengthen the medial flap. On lateral flap, small triangle just above the cutaneous roll is used to prevent unesthetic shortening of upper lip. This allows better continuity of the Cupid’s bow and ideal distribution of tension.Case presentationAs a modification to original method, orbicularis oris muscle overlapping suture is applied to make the elevated philtral ridge. Concomitant primary rhinoplasty also results in good esthetic outcome with symmetric nostrils and correction of alar web. As satisfactory results were obtained in three incomplete and one complete unilateral cleft lip patients, indicating Fisher’s method can be useful in cleft lip surgery with functional and esthetic outcome.ConclusionsClinically applied Fisher’s method in unilateral cleft lip patients proved the effectiveness in improving the esthetic results with good symmetry. This method also applied with primary rhinoplasty.

Surgical Treatment of Residual Distal Intimal Flap during Eversion Carotid Endarterectomy

Eversion carotid endarterectomy (ECEA) is an effective surgical technique for the treatment of internal carotid artery (ICA) stenosis. However, a residual distal intimal flap may determine a higher rate of neurological complications. The treatment of DIF may be challenging, and no definitive approach has been described. We describe a simple surgical option for the treatment of DIF. After internal ECEA has been performed, stitches are positioned at the side of intimal flap. Suture sequence is performed from internal-external-external-internal artery wall including the everted ICA, maintaining the suture thread inside the vessel. Once the ICA is correctly repositioned, the suture thread is pulled out. Once the standard carotid anastomosis has been performed, the flap is finally tacked. Fifteen patients have undergone surgical repair of DIF with the modified technique. No patients developed neurological complications after the surgical procedure, and all patients are still alive at last follow-up visit. This simple technique seems a safe and feasible surgical option to correct DIF, avoiding challenging surgical procedures that may increase operative and clamping time.

Fibular flap for mandible reconstruction in osteoradionecrosis of the jaw: selection criteria of fibula flap.

BackgroundOsteoradionecrosis is the most dreadful complication after head and neck irradiation. Orocutaneous fistula makes patients difficult to eat food. Fibular free flap is the choice of the flap for mandibular reconstruction. Osteocutaneous flap can reconstruct both hard and soft tissues simultaneously. This study was to investigate the success rate and results of the free fibular flap for osteoradionecrosis of the mandible and which side of the flap should be harvested for better reconstruction.MethodsA total of eight consecutive patients who underwent fibula reconstruction due to jaw necrosis from March 2008 to December 2015 were included in this study. Patients were classified according to stages, primary sites, radiation dose, survival, and quality of life.ResultsFive male and three female patients underwent operation. The mean age of the patients was 60.1 years old. Two male patients died of recurred disease of oral squamous cell carcinoma. The mean dose of radiation was 70.5 Gy. All fibular free flaps were survived. Five patients could eat normal diet after operation; however, three patients could eat only soft diet due to loss of teeth. Five patients reported no change of speech after operation, two reported worse speech ability, and one patient reported improved speech after operation. The ipsilateral side of the fibular flap was used when intraoral soft tissue defect with proximal side of the vascular pedicle is required. The contralateral side of the fibular flap was used when extraoral skin defect with proximal side of the vascular pedicle is required.ConclusionsOsteonecrosis of the jaw is hard to treat because of poor healing process and lack of vascularity. Free fibular flap is the choice of the surgery for jaw bone reconstruction and soft tissue fistula repair. The design and selection of the right or left fibular is dependent on the available vascular pedicle and soft tissue defect sites.

Aeroacoustic Simulations of a Simplified High-Lift Device Accounting for Some Installation Effects

The aeroacoustic noise of a simplified wing-flap configuration placed in an open-jet anechoic wind tunnel is investigated by compressible wall-resolved large-eddy simulations possibly coupled with the Ffowcs-Williams and Hawkings acoustic analogy. The numerical domain includes the nozzle and the anechoic chamber, which allows the direct taking of the installation effects into account. The simulated span (25% of the flap chord) is the largest one simulated so far for this configuration and, more generally, at this high Reynolds number. The results of the simulation are validated with the extensive experimental database for the chosen configuration. A good overall agreement with experimental data is achieved for all mean and fluctuating velocities, as well as wall pressures on the wing and the flap, especially the power spectral densities, the convection velocities, and even the streamwise and spanwise coherences on both elements. Similar good predictions of the far-field acoustic pressure using a hybrid approach are achieved, although the acoustic analogy does not allow taking into account the jet noise given that the Ffowcs-Williams and Hawkings surfaces are placed within the jet core. The acoustic results obtained with the acoustic analogy are also compared with the numerical microphones placed in the far field, showing a good agreement up to the mesh cut-ff frequency. The dilatation field and the sound directivity stress that the flap and wing trailing edges are the dominant noise sources of the wing-flap configuration, with significant diffraction effects on the flap side. Evidence of slight boundary-layer instabilities is also shown close to the flap trailing edge.

Upper lip lift with a “T”-shaped resection of the orbicularis oris muscle for Asian perioral rejuvenation: A report of 84 patients

An overlong upper lip or philtrum indicates aging. In the current study, a procedure for upper lip lift to alleviate this defect is illustrated and assessed for its esthetic effects and risks. A total of 84 Chinese patients with overlong upper lip underwent surgery for upper lip lift from 2012 to 2014. Skin excision height was designed on the basis of the golden proportion of the lower region of the face. The incision was made at the subnasal (inferior border of the columella-nostril-alar) region. After undermining the tissue between the subcutis and orbicularis oris, a "T"-shaped region of the muscle was resected. Both sides of the muscular flaps were developed and suspended upward to the columella base to lift the upper lip. The incision was then sutured delicately. Of the 76 patients who were effectively followed up, recovery period, lift effect, visibility of the scar, vermilion shape, surgery-associated effects, any complications, and overall rejuvenation, among other outcomes, were evaluated at 1 week, 1 month, and 3-24 months postoperation. Assessment was performed by both objective measurements and subjective satisfaction: significant efficiency was achieved and high satisfaction, satisfaction, and dissatisfaction ratings were reported by 55 (72.4%), 18 (23.7%), and 3 (3.9%) patients, respectively. Upper lip lift yields a significant esthetic effect with few complications. This surgical intervention merits further clinical development and application.

Reconstruction of thumb and fingertip defects with wrap-around flap from the big toe

Objective To evaluate the method and clinical outcomes of big toe composite tissue flap transplantation with fibular branch of the proper plantar artery as feeding vessel for coverage of thumb and finger tip defects. Methods From January 2013 to June 2015, 6 cases with thumb tip defects and 9 cases with fingertip defects were repaired by the big toe composite tissue flap transplantation with anastomosing fibular branch of the proper plantar artery to the feeding vessel. Donor site of the big toe was covered by a tibial side flap. Results All 15 wrap-around flaps from the big toe survived. Postoperative follow-up ranged from 3 to 14 months. All the reconstructed digits had favorable functions and nail growth. The reconstructed nail was smooth in 13 cases and uneven in 2 cases. Scar hyperplasia and contracture was seen in 1 case. There is no abrasion or ulceration of the flaps that covered the donor site. Conclusion Big toe composite tissue flap transplantation with fibular branch of the proper plantar artery as feeding vessel is a less invasive and reliable method for coverage of thumb and fingertip defects. Key words: Surgical flaps; Finger injuries; Proper plantar artery

Platelet-rich plasma reduces skin flap inflammatory cells infiltration and improves survival rates through induction of angiogenesis: An experiment in rabbits

Background: This study was conducted to evaluate the effects of platelet-rich plasma (PRP) on flap survival in an experimental rabbit model. Methods: Symmetrical rectangular dorsal cutaneous flaps (8 × 2 cm) were elevated in 15 rabbits. The rabbits were randomly divided into a 3-day group (n = 5), a 7-day group (n = 5), and a 14-day group (n = 5). Either side of the dorsum was selected for injection of PRP into the flap basal surface, while the other side received an equal volume of saline as a control. The flaps were immediately sutured back, after which the flap survival was measured and histology specimens were collected at 3, 7, and 14 days. Results: Platelet-rich plasma significantly improved flap survival rates of the PRP side flaps relative to the control in the 3-day (74.4% ± 4.7% vs 65.8% ± 6.8%; p < 0.05), 7-day (72.4% ± 7.5% vs 58.5% ± 7.0%; p < 0.05), and 14-day (74.5% ± 5.0% vs 65.0% ± 5.4%; p < 0.05) groups. Histological analysis revealed significantly fewer inflammatory cells and an increased blood vessel density in the platelet-rich plasma side flap vs the blank control side flap. Conclusion: Platelet-rich plasma (PRP) promotes the survival of random rabbit flaps and, therefore, represents a promising treatment to prevent skin flap necrosis in reconstructive and plastic surgery.