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DOI: 10.1055/s-2008-1064927
Combined Cremaster Muscle and Inner Thigh Skin Composite Flap: A Novel Experimental Flap Model in the Rat
Publication History
Publication Date:
07 March 2008 (online)
ABSTRACT
Unlike the composite musculocutaneous flap models, the combined composite muscle-skin flap model allows evaluating muscle and skin viability independently, because it has an independent blood supply to the muscle and skin component. However, to our knowledge, only two combined muscle-skin flaps have been reported to date. During our cremaster dissection in our laboratory, we perceived a new vessel as a terminal continuation of the pudic-epigastric artery (PEA) on which the cremaster muscle flap is raised. Therefore, we designed this study to determine whether the scrotal and inner thigh skin can be harvested with the cremaster muscle as a combined cremaster muscle-skin composite flap. Thirty male Sprague-Dawley rats were used in this experiment. In five rats, ink study selective to the PEA marked a skin territory. In 15 rats, cremaster muscle and 4 × 3 cm ipsilateral scrotal and medial thigh skin flap was raised on the PEA. Fluorescein study after 4 hours showed fluorescein stain in the skin island. On postoperative day 7, both muscle and skin components of the flaps were viable. Microangiographic study after the flap elevation revealed the vascularity of all components of the flap and clearly identified the branch to the skin island. To the best of our knowledge, this is the first report describing the combined flap model including the cremaster muscle. Our flap seems to have an important advantage over the other combined muscle-skin flap models in terms of the cremaster muscle being suitable for the intravital microscopy. Additionally, the two components of the flap have separate nutrient vessels with adequate length, which gives the flap flexibility in the placement of the skin component in a location distant from the muscle component. The flap may be also be raised as a skin flap without the cremaster muscle. It can be used for different applications, including microcirculatory, pharmacological, physiological, biochemical, and immunological studies as well as for transplantation studies.
KEYWORDS
Experimental flap model - combined flap model - cremaster muscle
REFERENCES
- 1 Agaoglu G, Siemionow M. Combined semimembranosus muscle and epigastric skin flap a new model of composite-free flap in the rat. Ann Plast Surg. 2005; 55 310-315
- 2 Yeh L S, Hou S M, Lin A C, Lin J. A modified free gracilis flap in the rat. Microsurgery. 1994; 15 322-326
- 3 Chen S G, Zhang F, Komorowska-Timek E, Lineaweaver W C, Bunke H J. Free microvascular transfer of the acromiotrapezius osteomuscular flap in rats. Br J Plast Surg. 2000; 53 612-615
- 4 Ozkan O, Akyurek M, Safak T, Kayikcioglu A, Guler G, Erk Y. A new flap model in rats: iliac osteomusculocutaneous flap. Ann Plast Surg. 2001; 47 161-167
- 5 Mutaf M, Tasaki Y, Arakaki M, Fujii T. A true osteomyocutaneous free-flap model in rats: the saphenous artery osteomyocutanous flap. Plast Reconstr Surg. 1995; 96 1629-1635
- 6 Linsell M, Jablonski P, Howden B, Scott D, Marshall V. The thigh flap: an osteomyocutaneous free flap model in the rat. Plast Reconstr Surg. 1988; 81 240-245
- 7 Nasir S, Aydin A, Kayikcioglu A, Sokmensuer C, Cobaner A. New experimental composite flap model in rats: gluteus maximus-tensor fascia lata osteomuscle flap. Microsurgery. 2003; 23 582-588
- 8 Chen S G, Xu X Z, Zhang F, Hui K, Lineaweaver W C, Buncke H J. Free vascularized fibular bone flap in the rat. Microsurgery. 2000; 20 1-5
- 9 Zhang F, Lineaweaver W C, Kao S et al.. Microvascular transfer of the rectus abdominis muscle and myocutaneous flap in rats. Microsurgery. 1993; 14 420-423
- 10 Akyurek M, Safak T, Manavbasi I, Kecik A. A rat musculocutaneous flap model: the biceps femoris musculocutaneous flap. Ann Plast Surg. 2000; 45 305-312
- 11 Akyurek M, Safak T, Kayikcioglu A, Ozkan O, Manavbasi I, Kecik A. A new flap model in the rat: the pectoral skin flap. Ann Plast Surg. 1999; 42 185-192
- 12 Dautel G, Braga da Silva J, Merle M. Pedicled or free transfer of the gracilis muscle in rats. J Reconstr Microsurg. 1991; 7 23-25
- 13 Ionac M, Geishauser M. The combined gracilis and semitendinosus free flap in the rat. J Reconstr Microsurg. 1998; 14 237-243
- 14 Brunelli A, Lagagneux J, Vignes J L, Bottini D J. A new free flap model in the rat: the pectoralis major muscle. Br J Plast Surg. 2005; 58 455-459
- 15 Ozkan O, Akyurek M, Safak T, Acar B, Ozgentas H E, Kecik A. Neuromuscular and neuromusculocutaneous flaps in the rat. J Plast Reconstr Aesthet Surg. 2006; 59 279-290
- 16 Zhang F, Kao S D, Walker R, Lineaweaver W C. Pectoralis major muscle free flap in rat model. Microsurgery. 1994; 15 853-856
- 17 Dogan T, Kryger Z, Zhang F et al.. Quadriceps femoris muscle flap: largest muscle flap model in the rat. J Reconstr Microsurg. 1999; 15 433-437
- 18 Ozkan O, Coskunfırat O K, Ozgentas H E. A new experimental flap model: free muscle perforator flap. Ann Plast Surg. 2003; 51 603-606
- 19 Koudsi B, Khouri R K. Thigh adductor flap: an experimental model for free flap transfer in the rat. Microsurgery. 1992; 13 338-339
- 20 Yim K K, Lineaweaver W C, Siko P P, Buncke H J. Microvascular transfer of anterior and posterior gracilis muscles in rats. Microsurgery. 1991; 12 262-267
- 21 Briones R, Lineaweaver W C, Newlin L, Whitney T M, Buncke H J. Single pedicle microvascular transfers of the serratus anterior and latissimus dorsi muscles in rats. Microsurgery. 1989; 10 269-273
- 22 de la Pena J A, Lineaweaver W, Buncke H J. Microvascular transfers of latissimus dorsi and serratus anterior muscles in rats. Microsurgery. 1988; 9 18-20
- 23 Zhang F, Sones W D, Lineaweaver W C. Microsurgical flap models in the rat. J Reconstr Microsurg. 2001; 17 211-221
- 24 Anderson G L, Acland R D, Siemionow M, McCabe S J. Vascular isolation of the rat cremaster muscle. Microvasc Res. 1988; 36 56-63
- 25 Acland R D, Anderson G, Siemionow M, McCabe S. Direct in vivo observations of embolic events in the microcirculation distal to a small-vessel anastomosis. Plast Reconstr Surg. 1989; 84 280-288 , discussion 289
- 26 Meininger G A, Fehr K L, Yates M B. Anatomic and hemodynamic characteristics of the blood vessels feeding the cremaster skeletal muscle in the rat. Microvasc Res. 1987; 33 81-97
- 27 Ozer K, Zielinsky M, Unsal M, Siemionow M. Development of mouse cremaster transplantation model for intravital microscopic evaluation. Microcirculation. 2002; 9 487-495
Can CinarM.D.
Anadolu Sağlık Merkezi, Anadolu Cad. No. 1 Bayramoğlu Çıkışı
Çayırova Mevkii, Gebze 41400 Kocaeli, Turkey