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[Comparative study on different pedicles based sural neurofasciocutaneous flaps].

OBJECTIVE
To investigate a best method of obtaining the sural neurofasciocutaneous flap by observing the models of different pedicles based sural neurofasciocutaneous flaps in rabbits and the effect of different pedicles on the survival of the flaps.


METHODS
Forty adult New Zealand rabbits (male or female, weighing 2.5-3.0 kg) were randomly divided into 4 groups (10 rabbits in each). The flaps of 7 cm x 1 cm were designed at the lateral hind legs, and the pedicle was 0.5 cm in length. In group A, the flaps were elevated based on a single perforator pedicle; in group B, the flaps were elevated based on fascia pedicle; in group C, the flaps were elevated based on perforator-plus fascia pedicle; and in group D, the flaps were elevated and sutured in situ. At 7 days after operation, the flap survival rate was recorded, and the blood flow in the center of the flap was monitored by laser Doppler flowmetry. The perfusion unit (PU) was measured.


RESULTS
After operation, the flaps had no obvious swelling, and the flaps had good color at the proximal end, but pale at the distal end in groups A and B. Obvious swelling was observed with pale color at the distal flaps in group C, but swelling decreased gradually. However, the skin color became dark gradually in group D after operation. The flap survival rates were 74.0% +/- 2.7%, 60.0% +/- 2.5%, 75.0% +/- 3.5%, and 0 in groups A, B, C, and D respectively after 7 days of operation. The PU values were 83.39 +/- 4.25, 28.96 +/- 13.49, 81.85 +/- 5.93, and 8.10 +/- 3.36 in groups A, B, C, and D respectively. There were significant differences in flap survival rates and PU values between groups A, B, C and group D (P < 0.05). Significant differences were found between groups A, C and group B (P < 0.05), but no significant difference between group A and group C (P > 0.05).


CONCLUSION
The sural neurofasciocutaneous flap based on a single perforator pedicle has a reliable blood supply and enough venous drainage, which is one of the best methods to obtain the sural neurofasciocutaneous flap.