Purpose:  Angiogenesis occurs in arteries exposed to pulsed magnetic energy (PME).  Using a rat groin cutaneous flap model, we created a neo-vasculature by anastomosing the tail artery to the femoral artery and placing it under the groin and abdominal skin.  We propose that transplanted arterial loops treated with PME will support the skin flaps even when the superficial inferior epigastric vessels are divided.

Methods:  Male Sprague-Dawley rats (6-7 per group) were divided into 6 groups.  The tail artery (12-cm) was anastomosed end-to-end or end-to-side to the right femoral artery proximal to the superficial epigastric artery and placed under the skin.  Experimental groups received 12 weeks of PME for 30 min twice a day.  After 12 weeks, all groups had an 8- x 4-cm skin flap raised and the superficial epigastric artery, or both s. epigastric artery and vein were ligated, as designed:

 

	anastomosis	PME	division of s. epigastric…	% flap survival
Group 1 (control)	end-to-end	no	artery & vein	17
Group 2 (experimental)	end-to-end	yes	artery & vein	1
Group 3 (control)	end-to-end	no	artery	82
Group 4 (experimental)	end-to-end	yes	artery	89
Group 5(control)	end-to-side	no	artery	26
Group 6 (experimental)	end-to-side	yes	artery	79

On day 5, the area of viable skin was traced onto velum paper, randomly renumbered, and the

percentage of viable skin over total surface area calculated.

Results:  Dividing the superficial epigastric vein results in flap necrosis (p<0.01); however, all flaps with intact venous drainage had significant flap survival based solely on the transplanted arterial loop (p<0.05).  In the end-to-side group, treatment with PME significantly improved flap survival (26% vs.79%, p=0.01). Treating the end-to-end loop for 12 weeks does not appear to increase survival of the flap over control. 

Conclusions:  Venous drainage is essential to flap survival.  The cutaneous flap is able to survive purely on circulation from the transplanted arterial loop.  PME treatment in the end-to-side group significantly improves survival of the flap.  PME may have a role in the prefabrication of flaps.