Influence of diabetes on critical flaps based on the vascular axis of a sensory nerve.
Delayed sural flap based on the vascular axis of the sural nerve has been advocated for coverage of diabetic foot ulcers. In this study we compared the survival of neurovenous and standard inferior epigastric island flaps in diabetic and non-diabetic rats. VEGF concentrations and electrolyte balance of the flaps were also investigated during elevation and on the fifth day to explore the possible mechanisms that influence ischaemia of the flap during the hyperglycaemic state. There were no statistical differences in area surviving between diabetic and control rats for either flap. The VEGF concentrations were also similar in the two flaps in the two groups during elevation. On the fifth day, VEGF concentrations had decreased significantly in all of the flaps. Electrolyte balance paralleled VEGF concentrations. We conclude that flaps based on the vascular axis of a superficial nerve deserve further experimental and clinical attention as potential options for reconstruction of ulcers on diabetic feet.
Demir
Ahmet
A
Department of Plastic Reconstructive and Aesthetic Surgery, Medical Faculty, Ondokuz Mayis University, TR-55139 Samsun, Turkey. arbdemir@omu.edu.tr
Karacalar
Ahmet
A
Diraman
Emine
E
Simşek
Tekin
T
Korkmaz
Adnan
A
Sakallioğlu
Eser
E
D000818:Animals; D003921:Diabetes Mellitus, Experimental / Q000503:physiopathology* / Q000601:surgery; D008297:Male; D011897:Random Allocation; D051381:Rats; D017207:Rats, Sprague-Dawley; D013497:Sural Nerve; D013524:Surgical Flaps / Q000098:blood supply / Q000294:innervation / Q000502:physiology*; D042461:Vascular Endothelial Growth Factor A / Q000032:analysis*
D042461:Vascular Endothelial Growth Factor A