Experimental Study On The Effect Of Geometric Modified Incision On Narrow Pedicle Flap And Clinical Application

Objective: To study the Survival mechanism of narrow pedicle flap, by investigating the effects of the different geometric design on the survival area of congested flap.Method: 16 New Zealand white rabbits were randomly designed two congested flap with the same area and different shapes on either side of rabbit’s back. The flaps were randomly arranged into control group and flaps on other side served as the other shapes. We observed and measured the flap through HE dyeing, survival area, the expression of HIF-1α by ELISA on the flap at different time, in the postoperative 12 h, 1d, 2d, 3d, 5d, 7d.Result: The results for the critical size of the flap necrotic area when congestion is equal to the circumference of the longer flap graphical their blood stasis, the more the amount of leakage that flap congestion will be reduced expression of hypoxia-inducible factor increases, flap survival area proportion increases. An increase in the amount of leakage of blood stasis, while optimizing the geometry of the flap after flap design also helps heal scar contracture formed depressions corresponding complications. With the same area, the number of micro-thromb and the necrotic area for round flap, square flap, triangle flap and the gear-shaped flap reduce successively. And in a certain range, the number of HIF for them increase progressively.Clinical application: According to the shape of the site and size of the defect, the long and narrow pedicle congestive flap was designed with “reversing method” according to the position and the size of the defect on the conceal position or well-being tissue away from the defect. Increasing the circumference of incision combined with Z plasty. Drainage strips are placed which come from half of the drainage tube(length wise) under flap after ropration, and vacuum sealing drainage was placed over the flap, then aspirate blood detaining in flap and bellow flap on negative pressure initiatively in time. Vacuum sealing drainage and drainages were demolished after 3 days.Results: The results for the critical size of the flap necrotic area when congestion is equal to the circumference of the longer flap graphical their blood stasis, the more the amount of leakage that flap congestion will be reduced expression of hypoxia-inducible factor increases, flap survival area increases. An increase in the amount of leakage of blood stasis, while optimizing the geometry of the flap after flap design also helps heal scar contracture formed depressions corresponding complications. part of clinical application: this flaps survived with good texture, elasticity and color.Its long-term effect appearance well.Conclusions: The improved design of geometrical theory, increasing girth can promote flap survival of the same size and play a facilitating role to its long-term appearance. It is easily performed and very practical to prevent or lessen congested flap.