Prefabricated osteocutaneous neural island flap model.

Abstract

Neural-based flaps are an interesting clinical choice particularly in difficult cases that may not be reconstructed with known techniques. Their popularity is gradually increasing because these flaps offer the advantage of preservation of major extremity arteries and avoidance of microsurgical techniques. Our aim was to explore the feasibility of prefabrication of an osteocutaneous neural island flap model in this study. A peripheral nerve of the rat was implanted into the subcutaneous tissue of a skin flap that was connected to a segment of bone by a soft-tissue bridge, to prefabricate an osteocutaneous flap that was supplied only by the intrinsic vasculature of that nerve after a preliminary delay period. At the end of this study, based on direct observation, microangiographic findings, and additionally, a detailed histologic analysis consisting of both qualitative and quantitative assessments, we have proved that it was possible to prefabricate an osteocutaneous composite flap based on the vascularity of a peripheral nerve after a 2-step delay period. We believe that the clinical application of this new flap will gradually develop based on further experimental studies.