The influence of pedicle length on the viability of twisted perforator flaps in rats

The pedicled perforator flap is now regarded as a valuable tool in the reconstructive armamentarium, but variable degrees of perforator twisting upon flap transposition are frequently encountered intraoperatively. The aim of this study was to investigate the effect of pedicle length on twisted perforator flap viability. Forty Sprague-Dawley rats were randomly divided into four groups of 10 animals each: group I (short pedicle, no rotation), group II (short pedicle, 720 degrees rotation), group III (long pedicle, no rotation), and group IV (long pedicle, 720 degrees rotation), and cranial epigastric artery perforator flaps were elevated. Mean group flap survival ratios were 88.47±13.87% (group I), 60.23±28.95% (group II), 87.06±13.85% (group III), and 84.28±31.76% (group IV). Viable flap ratios in group II were significantly lower than in groups I, III, and IV, respectively (p<0.05). Our findings suggest that when perforator twisting is unavoidable, longer pedicles are significantly more likely to result in secure flap survival.