Prefabricated flap composed by skin and terminal gastromental vessels. Experimental study in rabbits.
BACKGROUND
The angiogenic induction property of the omentum makes it a promising pedicle for prefabricating flaps. Therefore, the objective of this paper is to establish the abdominal area to be prefabricated by the omental pedicle and to analyse the prefabricated potential (PP) according to the time delay between the pedicle introduction and the flap release.


METHODS
Forty-four rabbits were divided into four groups (A, B, C and D). In group A, a piece of skin, subcutaneous tissue and abdominal cutaneous muscle was fully released and sutured again in place. In the other groups, a 9-cm2 omental pedicle containing the gastromental vessels distally tied was transposed and sutured to abdominal cutaneous muscle. A second procedure, consisting of incision and release of the flap that contained skin, subcutaneous and cutaneous abdominal muscle pediculated only by the omentum, was carried out. The only variation was the time delay between the two procedures: 7, 21 and 56 days for groups B, C and D, respectively. The flaps were inspected 15 days after the last procedure. The pieces of viable area were immunostained using anti-CD31 for estimation of the microvascular density.


RESULTS
The mean and maximum viable areas in group D were 45.29 and 99.37cm2, respectively (average PP=5.03 and maximum PP=11.04). There was no significant difference between the viable areas in groups C and D. The mean microvascular densities of groups B, C and D were 24.54, 33.20 and 27.03 vessels/mm2, respectively.


CONCLUSIONS
The omental tissue has great potential for prefabrication of flaps, and the delay time for the second procedure should be at least 21 days.
de Figueiredo
Jason César Abrantes
JC
Brazilian Society of Plastic Surgery, São Paulo, SP, Brazil; Santa Cruz Plastic Surgery Institute, São Paulo, SP, Brazil.
Naufal
Renato Rodrigues
RR
Claro de Oliveira
Francisco
F
Arias
Victor
V
Bueno Pereira
Paulo Roberto
PR
Inaco Cirino
Luís Marcelo
LM
D000009:Abdominal Muscles / Q000098:blood supply*; D000818:Animals; D006085:Graft Survival; D008297:Male; D055806:Microvessels; D023421:Models, Animal; D018919:Neovascularization, Physiologic / Q000502:physiology*; D009852:Omentum / Q000098:blood supply*; D011817:Rabbits; D012867:Skin / Q000098:blood supply*; D013524:Surgical Flaps / Q000098:blood supply* / Q000473:pathology; D013536:Suture Techniques; D014945:Wound Healing