title: Is It Possible to Increase Flap Viability by Hydrostatic Dilation?: An Experimental Study in the Rat Abdominal Fasciocutaneous Flap Model.
abstract: BACKGROUND
  Ergun et al previously demonstrated the efficacy of hydrostatic dilation in a TRAM flap model in an experimental study. We investigated the effect of hydrostatic dilation on a fasciocutaneous flap model.
  
  
  METHODS
  Eighteen female Wistar rats were equally divided into 3 groups, of which 1 served as a control. In the second, the abdominal fasciocutaneous flap surgical delay procedure was performed by division of the left superficial inferior epigastric (SIE) vessels. In the third, hydrostatic dilation was performed on the left SIE artery and vein, with a mean pressure of 300 mm Hg, while elevating the flap on the right-sided SIE pedicle. The groups were compared by microangiography and by the survival ratio of abdominal flaps 7 days after elevation.
  
  
  RESULTS
  The mean (SD) flap necrosis rates were as follows: control group, 44.75% (4.31%); delay group, 33.32% (7.11%); and hydrostatic dilation group, 32.51% (5.03%). There was a significant difference between the control group and the other 2 groups (P < 0.05). There was no difference between the delay and hydrostatic dilation groups with respect to surface area necrosis. The microangiographies showed remarkable increased vascularity in the delay and hydrostatic dilation groups.
  
  
  CONCLUSIONS
  Hydrostatic dilation is a new method of enhancing flap viability that could be used in clinical cases in place of surgical delay once further studies and clinical trials are completed.
authors.affiliation: From the *Department of Plastic and Reconstructive Surgery, Haydarpasa Training Hospital, Gulhane Military Medical Academy; and †New Age Clinic, Istanbul, Turkey.
authors.forename: Cihan
authors.initials: C
authors.lastname: Sahin
authors.forename: Bilge Kagan
authors.initials: BK
authors.lastname: Aysal
authors.forename: Ozge
authors.initials: O
authors.lastname: Ergun
mesh_terms: D000818:Animals; D004106:Dilatation / Q000379:methods*; D019074:Epigastric Arteries / Q000601:surgery; D005260:Female; D006874:Hydrostatic Pressure; D009336:Necrosis / Q000209:etiology / Q000517:prevention & control; D011183:Postoperative Complications / Q000517:prevention & control; D011897:Random Allocation; D051381:Rats; D017208:Rats, Wistar; D019651:Plastic Surgery Procedures / Q000379:methods*; D013524:Surgical Flaps / Q000098:blood supply* / Q000473:pathology; D014945:Wound Healing