Rate of elongation provided by multiple subcutaneous pedicle rhomboid flaps-an experimental study in the rat inguinal skin

PURPOSE: To investigate the rate of elongation provided by multiple subcutaneous pedicle rhomboid flaps. MATERIALS AND METHODS: Lower extremities of 20 male Sprague-Dawley rats were strained and fixed on a table to provide a tension line over the inguinal area. Two rhomboid shaped adjacent flaps with subcutaneous pedicles were designed over the tension line. Each flap was 1cm long and the distance between two flaps was 0.5 cm. The total pre-operative length was 2.5 cm. Flaps were incised and freed from the stretched skin. Tension line over the inguinal area was relieved by relaxation incisions. The resulting defects were then closed by suturing the rhomboid flaps in V-Y advancement along the tension line and in Y-V advancement along the relaxation incisions. The final elongation was measured and the results were analysed statistically. RESULTS: All relaxation incisions were effective in relief of tension over the inguinal area and in lengthening the tension line. Pre-operative 2.5 cm lengths ranged between 5.7 and 6.3 cm post-operatively (mean +/- standard deviation = 5.99 +/- 17 cm). The mean difference between pre- and post-operative measurements was 3.49 cm (139.6% gain in length). The subcutaneous pedicle rhomboid flaps easily closed all defects generated by relaxation and elongation. Statistical analysis revealed that two adjacent subcutaneous pedicle rhomboid flaps were efficient to close the defects generated by the relaxation incisions that produced a 139% gain in length (P < 0.001). CONCLUSION: The results of this experimental study show that multiple subcutaneous pedicle rhomboid flaps promise to be a good alternate technique in the treatment of long contracture bands in terms of rate of elongation and simplicity.