A supermicrosurgical flap model in the rat: a free true abdominal perforator flap with a short pedicle.

BACKGROUND: Perforator flaps have recently gained considerable popularity in reconstructive surgery, and their importance and advantages over conventional flaps have been widely accepted. Given the improvements in microsurgical techniques, researchers have encouraged the search for further perforator flap sources, such as a perforator flap with a short pedicle only. The purpose of this study was to describe a true perforator flap model with a short vascular pedicle in the abdominal region in the rat.
METHODS: Twenty-six adult Sprague-Dawley rats weighing 400 to 500 g were used. In 10 rats, the perforator vascular anatomy of the abdominal region was determined by anatomic dissection. In the remaining 16 rats, a true abdominal perforator-based flap was created based on a short segment of deep epigastric vessels. In eight rats, the flap was transferred to the groin region as a free flap, and anastomosis was performed between the artery and vein of the flap and the superficial inferior epigastric artery and vein of the recipient site. In addition, in two of these flaps, the long thoracic vein of the flap was anastomosed to the femoral vein. In the remaining eight rats, the flap was transferred to the groin region, but in this group anastomosis was not performed. The latter group was designated as the control group.
RESULTS: The skin islands of seven free perforator flaps survived completely, and the one remaining flap was determined to be necrotic. All the flaps in the control group underwent complete necrosis.
CONCLUSIONS: Not only is the free abdominal perforator flap a reliable and true perforator flap model for future physiological, biological, and pharmacological studies, it is also an excellent self-controlled supermicrosurgical training model for learning proper techniques, meticulous intramuscular dissection of true perforator flaps, and anastomosis of small-caliber vessels.