OBJECTIVE

To analyze vascular reaction in fasciocutaneous flaps after complete surgical denervation and primary ischemia.

MATERIAL AND METHODS

There were 3 series of experimental studies (white rats, n=53): 1) study of skin vessel anatomy within the marking of epigastric fasciocutaneous flap (n=3); 2) transposition of axial epigastric fasciocutaneous flap after its complete surgical denervation (periadventitial sympathectomy of vascular pedicle within 0.5-0.7 cm) and isolation of flap from surrounding tissues (n=25); 3) replantation of free epigastric flap in rats by P.G. van der Sloot (2002) (n=25). Vascular reaction in epigastric skin was investigated by intravascular injection of Gerota blue mass.

RESULTS

For the first time, vascular reactions in response to reperfusion of a free fasciocutaneous epigastric flap were described. They are characterized by significant dilatation and tortuosity of arteries and veins on the background of a 3-day post-reperfusion tissue edema. Dilation and tortuosity of skin vessels decreased by the 14th day, but did not completely disappear. After 10 postoperative days, fasciocutaneous flap engrafting was followed by normotrophic skin scar on the background of hemodynamic disorders and damaged mechanism of microcirculatory autoregulation. Arterial-venous vascular reactions in the reperfused fasciocutaneous flap persisted for 14 days. These reactions can be interpreted as a complex of reperfusion and neurogenic lesions of the muscular membrane of the skin vessels. At the same time, skin and fascia remain outside this reperfusion effect due to high tolerance to anoxia.