The gracilis myocutaneous free flap in swine: An advantageous preclinical model for vascularized composite allograft transplantation research

Authors

  • Angelo A. Leto Barone M.D.,

    1. Transplantation Biology Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA
    2. Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA
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  • David A. Leonard MB.ChB.,

    1. Transplantation Biology Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA
    2. Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA
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  • Radbeh Torabi M.D.,

    1. Transplantation Biology Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA
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  • Christopher Mallard B.S.,

    1. Transplantation Biology Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA
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  • Taylor Glor B.A.,

    1. Transplantation Biology Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA
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  • Joseph R. Scalea M.D.,

    1. Transplantation Biology Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA
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  • Mark A. Randolph M.A.S.,

    1. Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA
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  • David H. Sachs M.D.,

    1. Transplantation Biology Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA
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  • Curtis L. Cetrulo Jr M.D., Facs

    Corresponding author
    1. Transplantation Biology Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA
    2. Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA
    • Transplantation Biology Research Center, Massachusetts General Hospital, MGH East, Building 149-9019, 13th Street, Boston, MA 02129
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Abstract

Vascularized composite allotransplantation (VCA) has become a clinical reality, prompting research aimed at improving the risk-benefit ratio of such transplants. Here, we report our experience with a gracilis myocutaneous free flap in Massachusetts General Hospital miniature swine as a preclinical VCA model. Fourteen animals underwent free transfer of a gracilis myocutaneous flap comprised of the gracilis muscle and overlying skin, each tissue supplied by independent branches of the femoral vessels. End-to-end anastomoses were performed to the common carotid artery and internal jugular vein, or to the femoral vessels of the recipients. Thirteen of fourteen flaps were successful. A single flap was lost due to compromise of venous outflow. This model allows transplantation of a substantial volume of skin, subcutaneous tissue, and muscle. The anatomy is reliable and easily identified and harvest incurs minimal donor morbidity. We find this gracilis myocutaneous flap an excellent pre-clinical model for the study of vascularized composite allotransplantation. © 2012 Wiley Periodicals, Inc. Microsurgery 2013.

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