J Reconstr Microsurg 2008; 24(1): 043-051
DOI: 10.1055/s-2008-1064921
© Thieme Medical Publishers

The Effect of Perforator Location on Epigastric Perforator Flap Survival: An Experimental and Stereological Study in Guinea Pigs

Onder Tan1 , Duygu Ergen1 , Bekir Atik2 , Cemal Gundogdu3 , Ilknur Calik3 , Ismail Can4
  • 1Ataturk University, Medical Faculty, Department of Plastic Reconstructive and Aesthetic Surgery, Erzurum, Turkey
  • 2Yuzuncu Yil University, Medical Faculty, Department of Plastic Reconstructive and Aesthetic Surgery, Van, Turkey
  • 3Ataturk University, Medical Faculty, Department of Pathology, Erzurum, Turkey
  • 4Ataturk University, Medical Faculty, Department of Histology and Embriology, Erzurum, Turkey
Further Information

Publication History

Publication Date:
17 March 2008 (online)

ABSTRACT

One challenge most often seen in perforator-based flaps is the topographic relationship between the flap and its perforator, which determines flap design and pedicle length. Thirty female guinea pigs were used in this study. They were divided into four different groups including three experimental groups (n = 8), which were designed as central, lateral, and distal groups according to the perforator location, and one control group (n = 6). Flap survival and vessel density rates were assessed. There was no statistically significant difference (p > 0.05) among either the surviving skin areas or the vascular density rates of the experimental groups, although all flaps were necrosed in the control group. We concluded that perforator flaps can safely be raised on the perforators located very distal or lateral to the flaps, as well as central classical location. Moreover, perforator flaps larger than suggested can safely be harvested in the same donor sites.

REFERENCES

  • 1 Kroll S S, Rosenfield L. Perforator-based flaps for low posterior midline defects.  Plast Reconstr Surg. 1988;  81 561-566
  • 2 Allen R J, Treece P. Deep inferior epigastric perforator flap for breast reconstruction.  Ann Plast Surg. 1994;  32 32-38
  • 3 Blondeel P N, Boeckx W D. Refinements in free flap breast reconstruction: the free bilateral deep inferior epigastric perforator flap anastomosed to the internal mammary artery.  Br J Plast Surg. 1994;  47 495-501
  • 4 Koshima I, Moriguchi T, Soeda S, Tanaka H, Umeda N. Free thin paraumbilical perforator-based flaps.  Ann Plast Surg. 1992;  29 12-17
  • 5 Koshima I, Moriguchi T, Soeda S, Kawata S, Ohta S, Ikeda A. The gluteal perforator-based flap for repair of sacral pressure sores.  Plast Reconstr Surg. 1993;  91 678-683
  • 6 Verpaele A M, Blondeel P N, Van Landuyt K et al.. The superior gluteal artery perforator flap: an additional tool in the treatment of sacral pressure sores.  Br J Plast Surg. 1999;  52 385-391
  • 7 Gundersen H J, Jensen E B. The efficiency of systematic sampling in stereology and its prediction.  J Microsc. 1987;  147 229-263
  • 8 Gundersen H J, Bagger P, Bendtsen T F et al.. The new stereological tools: dissector, fractionator, nucleator and point sampled intercepts and their use in pathological research and diagnosis.  APMIS. 1988;  96 857-881
  • 9 Tunc A T, Turgut M, Aslan H, Sahin B, Yurtseven M E, Kaplan S. Neonatal pinealectomy induces Purkinje cell loss in the cerebellum of the chick: a stereological study.  Brain Res. 2006;  1067 95-102
  • 10 Taylor G I, Minabe T. The angiosomes of the mammals and other vertebrates.  Plast Reconstr Surg. 1992;  89 181-215
  • 11 Hallock G G, Rice D C. Cranial epigastric perforator flap: a rat model of a true perforator flap.  Ann Plast Surg. 2003;  50 393-397
  • 12 Okşar H S, Coşkunfirat O K, Ozgentaş H E. Perforator-based flap in rats: a new experimental model.  Plast Reconst Surg. 2001;  108 125-131
  • 13 Dorion D, Boyd J B, Pang C Y. Augmentation of transmidline skin perfusion and viability in transverse rectus abdominis (TRAM) flaps in the pig.  Plast Reconstr Surg. 1991;  88 642-649
  • 14 Unal B, Tan H, Orbak Z et al.. Morphological alterations produced by zinc deficiency in rat sciatic nerve: a histological, electron microscopic, and stereological study.  Brain Res. 2005;  1048 228-234
  • 15 Sonmez O F, Unal B, Inaloz S et al.. Therapeutic effects of intracarotid infusion of spermine/nitric oxide complex on cerebral vasospasm.  Acta Neurochir (Wien). 2002;  144 921-928

Yrd. Doc. Dr. Onder Tan

Ataturk Universitesi Tip Fakultesi, Yakutiye Arastirma Hastanesi

Plastik Rekonstruktif Ve Estetik Cerrah A.D. 25240-Erzurum, Turkey