Blood Flow after Warm Ischemia in Island Flaps: Latissimus Dorsi Myocutaneous and Epigastric Flaps in the Dog

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Abstract
Island latissimus dorsi myocutaneous flaps are compared with island epigastric flaps in the dog in terms of their ability to reestablish blood flow and maintain tissue viability after increasing periods of warm ischemia. Blood flow in the vascular pedicles of the flaps was measured after one minute to ten hours of ischemia with an electromagnetic flowmeter. The histological condition of the cutaneous and muscular portions of these flaps was examined with light microscopy at the end of the ischemia period and after reflow. In comparison to the epigastric flap, the latissimus dorsi myocutaneous flap had a greater baseline flow before ischemia, a greater rise in flow above baseline (reactive flow) after ischemia, and an equal resistance to ischemia in terms of preservation of reactive hyperemia, recovery of nutritive flow to the skin, degree of histological changes in the skin, and patency of the vascular pedicle. Despite the vulnerability of the muscular component of the latissimus dorsi myocutaneous flap to ischemia, the muscle perforators remain patent and the dermis survived even after eight hours of warm ischemia.
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