6. Marty FM, Montandon D, Gumener R, Zbrodowski A (1984) A new neurovascular flap model in the rat. Plast Reconstr The use of subcutaneous tissue flaps in the repair of soft tissue Surg 98: 700 defects of the forearm and hand: An experimental and clinical 11. Noreldin AA, Fukuta K, Jackson IT (1992) Role of perivenous study of a new technique. Br J Plast Surg 37: 93 areolar tissue in the viability of venous flaps: An experimental 7. Taylor GI, Gianoutsos MP, Morris SF (1994) The neurovascu- study on the inferior epigastric venous flap of the rat. Br J lar territories of the skin and muscles: Anatomic study and Plast Surg 45: 18 clinical implications. Plast Reconstr Surg 94: 1 12. Muller R, Lehrach F (1980) Haemorrheological role of platelet 8. Behan FC (1992) The fasciocutaneous island flap: An exten- aggregation and hypercoagulability in microcirculation: Ther- sion of the angiotoma concept. Aust NZ J Surg 62: 874 apeutical approach with pentoxifylline. Pharmatherapeutica. 2: 9. Behan FC, Terrill PJ, Ashton MW (1994) Fasciocutaneous is- 372 land flaps for orthopaedic management in lower limb recon- 13. Roth AG, Briggs PC, Jones EW, Heckler FR (1988) Augmen- struction using dermatomal precincts. Aust NZ J Surg 64:155 tation of skin flap survival by parenteral pentoxifylline. Br J 10. Hirigoyen MB, Rhee JS, Weisz DJ, Zhang WX, Urken ML, Plast Surg 41:515 Weinberg H (1995) Reappraisal of the inferior epigastric flap: INVITED COMMENTAR Y D. McCoombe neural tissue is inadequate in this model. The histologi- The study explores the basis of survival of pedicled flaps cal studies performed would indicate that this finding is of various configuration. The flap model chosen was the epigastric flap of the rat – allowing comparison of the due to fewer arterioles in the perineural tissue compared to the perivenular tissue, but the method by which this role of the axial nerve, axial vein and their correspond- quantative analysis is arrived at is not clear. ing perineural and venous aroelar tissue – with a flap de- sign based on the anatomical study of Hirigoyen . Behan , in his clinical work, has used the axis of cutaneous nerves in the pedicle of his flaps; however, the The study design is reasonable and extends the study the success of these flaps is not predicated solely on the of Noreldin  in including the neural axis as a potential source of flap nutrition. The illustrations and photo- neural axis, as care is taken to preserve the venous axes in addition to the fascial plexus graphs are clear and instructive in terms of the pedical structure. The results of the study, however, are inconclusive. References No significant results were obtained, apart from the ben- efit of maintaining an arterial axis in the pedical, which 1. Hirigoyen MB, Rhee JS, Weisz DJ, Zhang WX, Urken ML, is not disputed. The results of flap survival were disap- Weinberg MD (1996) Reappraisal of the inferior epigastric flap: pointing – particularly in comparison to Noreldin’s a new neurovascular flap model in the rat. Plast Reconstr Surg study, in which survival rates of venous flaps were up to 98: 700 90% of the flap area in contrast to this study, in which 2. Noreldin AA, Fukuta K, Jackson IT (1992) Role of perivenous aroelar tissue in the viability of venous flaps: an experimental the maximum mean survival was 6%. No indication of study on the inferior epigastric venous flap of the rat. Br J Plast the variation in flap survival was given. It is mentioned Surg 45: 18 in discussion that there was variation in flap survival, but 3. Murata K, Tamai S, Inada Y, Fukui A, Miyamata S (1999) this is not indicated in the results, and with mean values Transfer of a pedicled venous flap containing perivenous ar- oelar tissue and nerve: an experimental study. Br J Plast Surg of less than 10% flap survival, the distribution of results 52: 223 would have been of interest. 4. Behan FC, Terrill PJ, Ashton MW (1994) Fasciocutaneous is- In terms of the contribution of pedicle components to land flaps for orthopaedic management in lower limb recon- flap survival, the presence of an axial vein is obviously struction, using dermatol precincts. Aust N Z J Surg 64(3): paramount. As documented qualitatively here and qua- 155–66 ntitively by others , the perivenous and the perineural D. McCoombe ( ) epigastric aroelar tissue will, in conjunction, provide an Royal Parade, 3052 Parkville, adequate arterial axis. This study concludes that the peri- Victoria, Australia
European Journal of Plastic Surgery – Springer Journals
Published: Jul 17, 2000
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