Experimental Studies on Island Flaps

Milton, Stuart H.

doi:10.1097/00006534-197112000-00009

Cited by 46 publications

(10 citation statements)

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“…However, to design a flap the same width as the primary defect immediately adjacent to it that has essentially the same mobility characteristics and to expect this to not only close that defect but also to permit direct closure of its own larger secondary defect seems empirically daring. What is it about the design that enables this to occur when the rules of length/breadth ratio seem to be over‐ruled? 12 It was S. H. Milton in 1971 on the experimental studies on island flaps who said, ‘an island is safer than a peninsula’ 13 …”

Section: Discussionmentioning

confidence: 99%

The Keystone Design Perforator Island Flap in reconstructive surgery

Behan

2003

ANZ Journal of Surgery

318

376

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Section: Discussionmentioning

confidence: 99%

The Keystone Design Perforator Island Flap in reconstructive surgery

Behan

2003

ANZ Journal of Surgery

318

376

View full text Add to dashboard Cite

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“…[12] This is probably the basis of the additional safety provided by the flap in the presence of local or general risk factors. Thus, we recommend use of this technique, when a flap is needed, in the background of local problems such as a wide zone of induration (post inflammation), significant zone of injury (post-traumatic oedema), diabetic or hypertensive vasculapathy, vascular problems such as varicose veins or systemic problems such as renal or hepatic disease.…”

Section: Discussionmentioning

confidence: 99%

Keystone flaps in coloured skin: Flap technology for the masses?

Bhat¹

2013

Indian J Plast Surg

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Introduction:Viscoelastic properties of skin in coloured ethnic groups are less favourable compared to Caucasians for executing Keystone flaps. Keystone flaps have so far been evaluated and reported only in Caucasians. The potential of Keystone flaps in a coloured ethnic group is yet unknown.Aim:This article reviews the experience to reconstruct skin defects presenting in a coloured ethnic group, by using Keystone flaps, with a review of existing literature.Design:Uncontrolled case series.Materials and Methods:This retrospective review involves 55 consecutive Keystone flaps used from 2009 to 2012, for skin defects in various locations. Patient demographic data, medical history, co-morbidity, surgical indication, defect features, complications, and clinical outcomes are evaluated and presented.Results:In this population group with Fitzpatrick type 4 and 5 skin, the average patient age was 35.73. Though 60% of flaps (33/55) in the series involved specific risk factors, only two flaps failed. Though seven flaps had complications, sound healing was achieved by suitable intervention giving a success rate of 96.36%. Skin grafts were needed in only four cases.Conclusions:Keystone flaps achieve primary wound healing for a wide spectrum of defects with an acceptable success rate in a coloured skin population with unfavorable biophysical properties. By avoiding conventional local flaps and at times even microsurgical flaps, good aesthetic outcome is achieved without additional skin grafts or extensive operative time. All advantages seen in previous studies were verified. These benefits can be most appreciated in coloured populations, with limited resources and higher proportion of younger patients and unfavorable defects.

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“…[31][32][33] However, the critical times for ischemic tolerance of muscle flaps are short, in rat as well as in rabbit and pig models. [34][35][36][37][38][39][40][41] Antonini et al's study 8 indicates that VEGF-mediated vasodilator effect and capillary permeability enhancement seem to be the most reasonable explanation for the early protective effects of the ischemia musculocutaneous flap. Erdmann et al's study 42 shows that exogenous administration of VEGF has a direct protective effect on the endothelium in severely ischemic tissues.…”

Section: Discussionmentioning

confidence: 99%

Vascular Endothelial Growth Factor Upregulates Inducible Nitric Oxide Synthase Expression in the Muscle Flap Ischemia Model in the Rat

Chen¹,

Persons²,

Lin³

et al. 2008

J reconstr Microsurg

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The purpose of this investigation was to elucidate the regulation of inducible nitric oxide synthase (iNOS) expression by vascular endothelial growth factor (VEGF) in a muscle flap ischemia model in rats. The gracilis muscle flap model was chosen. Sixty adult male Sprague Dawley rats were randomly divided into two groups (n = 30). After 4 hours ischemia, the experimental group received VEGF treatment, and the control group was given saline in the same fashion. At time intervals of 0, 2, 6, 12, and 18 hours (n = 6 for each time interval) after injection, tissue samples were biopsied for reverse transcriptase polymerase chain reaction, routine hematoxylin-eosin staining, and CD31 immunohistochemical staining. The result showed that iNOS expression is increased in the gracilis muscle flap ischemia model in rats compared with the control group within 6 hours after ischemia (p < 0.05). In the VEGF group, iNOS expression increased rapidly over the first 2 hours, but no statistically significant difference was observed at 12 and 18 hours between the two groups (p > 0.05). We concluded that the application of VEGF could maintain the structure of capillaries and upregulate iNOS expression during the first 6 hours after ischemia in the ischemic muscle flap of a rat model. These findings may provide the evidence to study the mechanism of VEGF in improving flap survival.

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Experimental Studies on Island Flaps

Cited by 46 publications

References 0 publications

The Keystone Design Perforator Island Flap in reconstructive surgery

The Keystone Design Perforator Island Flap in reconstructive surgery

Keystone flaps in coloured skin: Flap technology for the masses?

Vascular Endothelial Growth Factor Upregulates Inducible Nitric Oxide Synthase Expression in the Muscle Flap Ischemia Model in the Rat

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