Acute blood flow changes in rapidly expanded and adjacent skin

Abstract

Random flaps raised in expanded skin demonstrate increased survival lengths when compared with flaps raised on an acute basis. Nutritive blood flow studies performed after skin expansion and elevation show augmented blood flows similar to those seen in conventionally delayed skin flaps. We utilized dermofluorometric analysis to study acute blood flow changes in sequentially, rapidly expanded porcine skin. Four subcutaneous pockets were developed in each of six pigs. The pockets were divided into the following three groups: (1) those with placement of a tissue expander inflated sequentially to 300 mL over four days and then totally deflated on day 6, (2) those with placement of a tissue expander that was not inflated, and (3) those with no tissue expander placed. Measurements were taken immediately before and after tissue expander manipulation in group 1 and daily in groups 2 and 3. Fluorescence was determined at points over and 4, 7, and 10 cm distal to the expander. Blood flow decreased immediately after skin expansion in areas over the tissue expander on days 0 and 1 and returned to baseline levels within 24 hours. Blood flow increased after tissue expander deflation on day 6 but returned to predeflation levels within 24 hours. Capillary blood flow increased over the duration of the study in all three groups. There was no significant difference in blood flow between and among the three groups on day 8, nor was there a significant difference in blood flow between and among sites over and distal to the tissue expander.