Comparison of the Effect of Bacterial Inoculation in Musculocutaneous and Fasciocutaneous Flaps

TLDR

The fasciocutaneous flap is a reliable reconstructive option, especially for chronic infected wounds, yet prior studies indicate the musculocutaneous flap better resists bacterial inoculation than random‑pattern flaps. The study compares bacterial inoculation effects in similarly sized fasciocutaneous and musculocutaneous flaps using a canine model. The authors employed a canine model with flaps of equal dimensions to evaluate bacterial inoculation outcomes. Both flap types exhibited similar necrosis areas, but the musculocutaneous flap showed greater bacterial inhibition and collagen deposition in its wound space.

Abstract

The skin fascia! flap is now recognized as a reliable flap for use in reconstructive surgery. The fasciocutaneous flap has been advocated for coverage of chronic infected wounds after debridement as an alternative to the musculocutaneous flap. Previous experimental and clinical studies have demonstrated the superior resistance of the musculocutaneous flap as compared to the random-pattern flap to bacterial inoculation. A canine model is presented for comparison of the effect of bacterial inoculation in fasciocutaneous and musculocutaneous flaps of similar dimensions. The area of skin necrosis secondary to bacterial inoculation was similar in these two flap types despite greater blood flow and skin oxygen in the fasciocutaneous flap. In a study of closed wound spaces formed by the deep surface of these two flap types, a greater degree of inhibition and elimination of bacterial growth and more collagen deposition are observed in the musculocutaneous wound space than in the fasciocutaneous flap.