title: Omental Flow-Through Flap: Experimental Hemodynamic Study.
abstract: BACKGROUND
  The omental flow-through flap (OFTF) is based on the use of an anatomic unit composed of the right gastro-omental artery (bypass) with its omental branch or branches supplying the greater omentum (flap). The greater omentum flap is known for its capacity of resistance to infection, for its use in the treatment of ischemic lesions and as a high-flow tissue. Several hypotheses regarding the hemodynamic behavior of a distal bypass with a flap were discussed in the literature. We made the assumption that the OFTF was a low peripheral resistance flap and that the greater omentum did not induce a steal phenomenon. We demonstrated the anatomical feasibility of the experimental model with a morphologic study in the pig. The mail objective of this study was to measure the blood flow to evaluate the hemodynamic effects of the OFTF.
  
  
  METHODS
  Twelve domestic pigs were used for this study. Four cadavers of pigs were dissected for the anatomic study of the OFTF, and 8 live pigs were used for the experimental surgery and hemodynamic measurements. Hemodynamic measurements were taken before transplantation on in situ arteries using periarterial ultrasonic flow transducers. After transplantation of the OFTF, flows were measured before, then during clamping and unclamping of the flap.
  
  
  RESULTS
  OFTF was feasible in the porcine model. With the experimental model, the flow increased by 56.15% in the distal part of the bypass after the implantation of the flap with decrease of peripheral resistances.
  
  
  CONCLUSIONS
  Our results suggest that the OFTF is a low resistance flap and that the greater omentum does not induce a steal phenomenon. This anatomic unit could be used to carry out simultaneously limb revascularization and cover a tissue loss.
authors.affiliation: Department of Vascular and Endovascular Surgery, Nancy University Hospital, Vandoeuvre les Nancy, France; INSERM 1116, University of Lorraine, Nancy, France; School of Surgery, University of Lorraine, Nancy, France; Experimental Interventional Imaging Laboratory, Aix-Marseille University, Marseilles, France. Electronic address: nicla.settembre@yahoo.com.
authors.forename: Nicla
authors.initials: N
authors.lastname: Settembre
authors.affiliation: Department of Vascular and Endovascular Surgery, Nancy University Hospital, Vandoeuvre les Nancy, France; INSERM 1116, University of Lorraine, Nancy, France; School of Surgery, University of Lorraine, Nancy, France; Experimental Interventional Imaging Laboratory, Aix-Marseille University, Marseilles, France.
authors.forename: Sergueï
authors.initials: S
authors.lastname: Malikov
mesh_terms: D000818:Animals; D001783:Blood Flow Velocity; D005240:Feasibility Studies; D006439:Hemodynamics; D023421:Models, Animal; D009852:Omentum / Q000098:blood supply* / Q000637:transplantation*; D012039:Regional Blood Flow; D013524:Surgical Flaps / Q000098:blood supply*; D034421:Sus scrofa; D014655:Vascular Resistance