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ISSN 2992-8559 (Electronic)
ISSN 1405-0625 (Print)

2004, Number 3

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Cir Plast 2004; 14 (3)

TRAM flap chemical delay in rats

Gutiérrez SE, Ramírez LSG

Language: Spanish
References: 20
Page: 120-125
PDF size: 121.56 Kb.


ABSTRACT

TRAM flap is considered an excellent alternative for breast reconstruction. Several alternatives have been developed to insure its lifespan especially when a greater extension is desirable. The objective of this study was to demonstrate chemical delay as an easy and secure option to increase the flap survival in the rat comparing it with surgical delay. An experimental study with 30 rats divided in 3 groups was designed. The control group without delay, the second with surgical delay and the third with chemical delay using 3% polydocanol. The survival rate of the skin island was significantly higher in the surgical and chemical delay groups. (p < 0.001). The chemical delay is a useful procedure to increase the survival rate of the skin island of the TRAM flap, with statistic results similar to those in the surgical delay group with the advantage it is technically easier, has no complications and avoids surgical procedure. The chemical delay can be clinically applied with fair safety when raising flaps of any kind that need to be insure its extension.


REFERENCES

  1. Smith JD, Pribaz JJ. Flaps. In: Achauer BM: Plastic Surgery. Indications, Operations, and Outcomes; Bruce M. Achauer. St Louis: Mosby, 2000: 261-290.

  2. Restifo RJ, Ahmed SS, Ward B, Scoutt L, Taylor K. Surgical Delay in TRAM flap breast reconstruction: A comparison of 7 and 14 day delay periods. Ann Plast Surg 1997; 38(4): 330-334.

  3. El-MrakbyHH, Milner RH. The vascular anatomy of the lower anterior abdominal wall: a microdissection study on the deep inferior epigastric vessels and the perforator branches. Plast Reconstr Surg 2002; 109: 539-543.

  4. Restifo RJ, Ahmed SS. TRAM flap Perforator ligation and the Delay Phenomenon: Development of an endoscopic/laparoscopic delay procedure. Plast Reconstr Surg 1998; 101(6): 1505-1511.

  5. Ribuffo D, Muratori L, Antoniadou K. A Hemodynamic approach to clinical results in the TRAM flap after selective delay. Plast Reconstr Surg 1997; 99(6): 1706-1714.

  6. Hudson DA. The surgically delayed unipedicled TRAM flap for breast reconstruction. Ann Plast Surg 1996; 36(3): 238-245.

  7. OzgentasHE, Shenaq S, Spira M. Study of the Delay Phenomenon in the rat TRAM Flap model. Plast Reconstr Surg 1994; 94(7): 1018-1024.

  8. Gillies HD. The tubed pedicle in plastic surgery. NY Med J 1920; 111: 1

  9. Milton SH. The effects of delay on the survival of experimental studies on pedicle skin flaps. Br J Plast Surg 1965; 22: 244.

  10. Callegari PR, Taylor GI, Caddy CM, Minabe T. An anatomic review of delay the phenomenon. I. Experimental studies. Plast Reconstr Surg 1992; 89: 397.

  11. Taylor GI, Corlett RJ, Caddy CM, Zelt RG. An anatomic review of the delay phenomenon. II. Clinical applications. Plast Recontr Surg 1992; 89: 408.

  12. Yang D, Morris SF. Comparison of two different delay procedures in a rat skin flap model. Plast Reconstr Surg 1998; 102(5): 1591-7.

  13. Morrissey WM, Hallock GG. The increase in TRAM Flap survival after delay does not diminish long term. Ann Plast Surg 2000; 44(5): 486-90.

  14. Pearl RM. A unifying theory of the delay phenomenon: recovery from the hiperadrenergic state. Ann Plast Surg 1981; 7: 102-112.

  15. Fineseth F, Cutting C. An experimental neurovascular island flap for the study of the delay phenomenon. Plast Reconstr Surg 1978; 61: 412.

  16. Murphy SF, Lawrence WT, Robson MC, Heggers JP. Surgical delay and arachidonic acid metabolites: evidence for an inflammatory mechanism: an experimental study in rats. Br J Plast Surg 1985; 38: 272.

  17. Rickard RF, Hudson DA. Influence of vascular delay on abdominal wall complications unipedicled TRAM flap breast reconstruction. Ann Plast Surg 2003; 50(2): 138-42.

  18. Sano K, Hallock GG, Rice DC. Venous interruption is unnecessary to achieve an adequate delay in the rat TRAM flap model. Plast Reconstr Surg 2003; 111(1): 300-5.

  19. Koracaoglu E, Yuksel F, Turan SO, Ziernowicz RJ. Chemical delay: an alternative to surgical delay experimental study. Ann Plast Surg 2002; 49(1): 73-80.

  20. Karacaoglu E, Cermik H, Yurdun T, Zienowicz RJ. Effect of long term application of epinephrine on rat skin vasculature: experimental study. Microsurgery 2002; 22(7): 288-94.




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