Demonstration of circulation haemodynamics in random pattern thinned skin flap (an experimental study).

ABSTRACT

BACKGROUND: Clinical applications and indications of the thin skin flap have been widely documented but its circulation haemodynamics are still controversial. An experiment was conducted on pigs to show the survival and circulation haemodynamics of random pattern thinned skin flap. METHODS: Group I Random pattern standard skin flaps; 5 x 5 cm (n=20 flaps), and 5 x 10 cm (n=20 flaps). Group II Random pattern thin skin flaps; 5 x 5 cm (n=20 flaps), and 5 x 10 cm (n=20 flaps). Group III Random pattern thin skin flaps with silicone sheet underneath; 5 x 5 cm (n=20 flaps), and 5 x 10 cm (n=20 flaps). RESULTS: The mean surviving skin area of the 5 x 10 cm flaps was 95.5% in Group I, 64.9% in Group II, and 33.67% in Group III. A statistically significant difference (P<0.05, ANOVA) was found between the groups. The mean surviving skin area of the 5 x 5 cm flaps was 100% in Groups I and II, and 68.2% in Group III. A statistically significant difference (P<0.05, ANOVA) was also found between Groups I and III, and Groups II and III. In microangiographical studies, the distribution of subcutaneous plexuses was clearly visible in Group I. In Group II the subdermal vascular plexus was observed less frequently and was thinner, particularly on the distal part of the flaps. In Group III dilatation of the subdermal vascular plexus was evident, particularly on the proximal section of the flaps. In the technetium-99m-labelled microspheres uptake of the 5 x 10 cm flaps, there was no statistically significant difference between the first segments in Groups I and II, Groups II and III (P>0.05, ANOVA). A significant difference was found between the second segments in Groups I and III (P<0.05, ANOVA). CONCLUSION: The results obtained in this study show that the effect of subdermal vascular plexus in the survival of the random pattern thinned skin flaps is supported by flap bed osmosis and plasma imbibition.