An Attempt to Keep Flaps Alive with Artificial Perfusion in Rabbits

Objective: In free flap surgery, the condition of recipient vessels may not be appropriate for anastomosis because of anatomical factors or acquired features such as tumoral invasion, surgical treatment, or radiotherapy. Furthermore, free flap surgery is time-consuming, expensive, demanding, and more prone to complications. The aim of this study was to test the hypothesis that maintaining free flap perfusion with a temporary artificial system without microanastomosis until revascularization is adequate for flap vitality.Materials and Methods: We studied a total of 14 rabbits, which were placed into two groups: control and experimental. A 5×5 cm free skin island flap was elevated on the caudolateral scapular region. In the experimental group, the artery and vein of the flaps were cannulated and a 5 cc/h plasma infusion was artificially started prior to flap fixation. In the control group,the flaps were designed and sutured to the recipient area without perfusion.Results: The animals did not live long enough for us to analyze the maintenance of the clinical flap vitality. However, it was found that flap tissues in the experimental group were vital during the first 6 days after surgery, while composite graft tissuesin the control group resulted in necrosis on day 3 in histopathological examination.Conclusion: Our experimental model proves that the artificial flap perfusion model with plasma perfusion extends the duration of tissue viability compared with that with non-perfusion (control group). This result could be improved with further investigations and may lead to the development of many future innovations.