Glucose metabolism in experimental skin flaps.

The metabolism of glucose by rat abdominal skin flaps has been investigated at various times after flap elevation. Biopsies of flap skin taken during the first 3 days after flap elevation and incubated in vitro show a marked increase in glucose consumption and lactate production compared with normal skin. At the same time, flap tissue reserves of glucose and glycogen are lower than those of normal skin. Providing that some circulation persists, the magnitude of the changes in glucose metabolism is proportional to the degree of ischemia experienced by the flap tissue in vivo. In most cases, glucose consumption and lactate production return to normal by the end of the first week after flap elevation. These experiments thus further define a major ischemia-induced shift to anaerobic metabolism (glycolysis) that occurs in skin flaps.