IPRAS

1). The Dunn test showed significant differences betweenpairs G1 and G2, G2 and G3, and G2 and G4 (p < 0.05).There was no statistical difference between G1 and G3,G1 and G4 and G3 and G4 groups (p > 0.05).Degloving injury performed. Proximal flow flap(A and B) and distal flow flap (C and D).Degloving injury performed. Lateral flow flap (A and B)and medial flow flap (C and D).G4 group. The necrotic flap area (cm2) was 0.51 for theG1 group, 3.64 for the G2 group, 0.39 for the G3 groupand 0.75 for the G4 group (p = 0.0001). The ratio betweenthe avulsed flap necrotic area and total area in the G1group was 0.041 (4.1%), 0.39 (39%) in G2, 0.09 (9%)in G3 and 0.08 (8%) in the G4 group. The comparisonbetween the means showed a statistically significantdifference among the four groups (p = 0.0001) (GraphicPartial flap necrosison postoperative day 7.Flap removed and placedon operative table.DiscussionThe simple repositioning of the avulsed flap in clinicalpractice often results in partial or total necrosis oftissue repositioned3. Thus, it is useful to develop anexperimental avulsion flap model so that it is possibleto test therapeutic modalities, in order to improve theoutcome of the repositioned flap.We could find three avulsion flap models4,5,6. None ofthese models were performed in the lower limbs. It wasconsidered important to develop a hind limb deglovingmodel in rats, closer to that observed in clinical practicein trauma centers, because the lower limb is the area mostoften affected in this type of injury.In addition, by using four different flap orientations, it wasobserved that the distal flow flaps were the most affected,having the poorest prognosis. The avulsion model withdistal flow (G2) represents a more severe injury, comparedto other flap orientations (proximal, medial or lateral flows).It presents a greater degree of ischemia and congestion,resulting in a more extensive necrotic area.Thus, we suggest the use of the distal flowgroupmodel(G2)to test drugs with potential improvement of flap viability,since this reverse flow flap allows easier observation of thedrug effects in decreasing the necrotic flap area.ConclusionThe distal flow group (G2) had a larger area of necrosisin relation to the total flap area and is considered the mostsuitable for testing therapeutic agents in avulsed flaps.References.1. Mandel M. The Management of Lower ExtremityDegloving Injuries. Ann Plast Surg. 1981; 6 (1): 1-5.2. Image J 1.42q for Macintosh. Versão 10.2. WayneResband National Institutes of Health, USA. Availableat: http://rsbweb.nih.gov/ij/download.html.3. Milcheski DA, Ferreira MC, Nakamorto HA, TumaJr P, Gemperli R. Tratamento cirúrgico de ferimentosdescolantes nos membros inferiores – proposta deprotocolo de atendimento. Rev Col Bras Cir. 2010;37(3): 195-203.4. Oztuna V, Eskandari MM, Unal S, et al. The effect ofpentoxifylline in treatment of skin degloving injuries:an experimental study. Injury 2006;37:638-641.5. Kurata T, O’Brien BM, Black MJ. Microvascularsurgery in degloving injuries: an experimental study.Br J Plast Surg 1978;31:117-120.6. Wang ZT, Guo SZ, Xiu ZF, et al. A new model ofskin avulsion injuries in rats. Chin J Plast Surg2008;24:212-215.40 IPRAS Journal www.ipras.org Issue 7