Development and utilization of a composite island flap employing omentum: experimental investigation.

In 39 pigs, four varieties of secondary island flaps were created using omentum as a carrier. This study demonstrates that: 1. Skin grafts (split- or full-thickness), when grafted to omentum, can be transformed into an "island flap," and the free transfer of this flap with microvascular anastomosis is feasible. 2. A skin flap, a combined skin flap, or both and subjacent muscle could be vascularized with omentum to obtain an omental island skin flap or an omental island musculocutaneous flap and transferred as already described. 3. Three varieties of secondary island osteocutaneous flaps were created using the omentum. Of these flaps, eight successfully underwent microvascular transfer. Bone vascularity and incontinuity viability were demonstrated by employing a variety of standard diagnostic techniques, including 99mTc-pyrophosphate tetracycline labeling, microangiography, and histologic sectioning. In addition to the many recognized advantages of a free living bone graft in reconstructive surgery, other benefits of this new kind of island composite flap include its unlimited size, minimal donor deformity, and ease of transfer. We have demonstrated that omentum can be used to vascularize skin, a skin flap, and either tibial, costal, or iliac bone graft to obtain a secondary island flap. The clinical uses of these flaps promise a new and exciting horizon in reconstructive surgery.