The importance of arterial inflow in the distal side of a flap: an experimental investigation.

Using abdominal skin flaps in experimental rats, we created flaps that exhibited relatively constant necrosis in the distal side. The existence of arterial inflow had a marked effect on the survival of the distal part of these flaps. We postulate that the so-called delay mechanism produces the arterial inflow as a consequence, although how this occurs is still unsolved. We suggest the possibility that a large flap may be transposed in one stage with vascular anastomosis in the distal part--preferably artery and vein, or artery only.