The Experimental Study Of Relationship Between Random Flap And Pedicle

Objective:Random flap is usually used to repair defects,but its clinical application of random has been strictly limited by its ratio of length to width for a long time.On the other hand,this theory of length to width ratio has been continually disputed by many scholars all the time.After reading a lot of documents and combining with clinic,we found that this theory was deficient in scientific confirmation.We concluded that:(1) the pedicle width was not the determinative factor of the survival length of random flap,and there was no direct ratio relationship between pedicle width and survival length;(2)Narrowing the pedicle of a random flap which can survive completely,transforming it into a kind of flap which ratio of length to width exceeds the limitation.This kind of flap,we named "narrow pedicle flap",can still survive completely.For confirming these views,we used the pig as experimental model.We hope that this experiment can provide a theory basic for the clinical application of narrow pedicle flap.Methods:Six white pigs were used.We randomly designed and made the traditional flaps and narrow pedicle flaps on both side of these animal's flanks.There were 3 flaps on each side,which pedicle went up and were parallel.There were 36 flaps totally(18 traditional flaps and 18 narrow pedicle flaps).The length,width and pedicle width of the traditional flap were all 8 cm,From the midline of back 5cm to the flap,the ratio of flap length to pedicle width is 1:1;That of the narrow pedicle flap were 8cm,8cm and 2cm,the ratio was 4:1.We observed the pathologic appearance of these flaps on different postoperative time,meanwhile measured these flaps temperature,then measured the survival length and made transparent specimen;finally carried out statistical analysis and judged whether there was significant difference between these flaps of the two groups.Results:1.There were 4 traditional flaps and 4 narrow pedicle flaps appeared distal skin necrosis.The average of survival length of the traditional flaps was 6.91cm(x=6.91cm); That of the narrow flaps was 6.83cm(x=6.83cm).There was no significant difference between the two groups(P＞0.05).2.The temperature of both groups had no significant difference(P＞0.05).3.Under naked eyes and microscope,we found that the pathologic appearance and revascularization of the two groups were similar and simultaneous.4.The transparent specimen indicated that the vascular distribution in two flaps was all homogeneous,and the revascularization of narrow pedicle flap might be more obvious.Conclusion:1.Pedicle width is not the determinative factor of the survival length of random flap;both are not the direct ratio relationship.2.Flap survival is to support and oxygen consumption of dynamic balance process,the territory of adjacent musculocutaneous perforators is the key factor of random flap surviving.3.Narrowing pedicle can't shorten the survival length of random flap.This experiment has provided a powerful theory basic for the clinical application of narrow pedicle flap.4.Because of its narrow,flexible,rotation Angle,wide coverage area,easily tissue removed and beautiful prognosis,the narrow pedicle flap has a broad prospect in clinical application.