Extrinsic Vascular Pathway Preservation Improves Survival in a Rat Three-territory Flap Model Based on the Deep Circumflex Iliac Artery

Extended flaps are commonly applied for large defects. However, a postoperative flap necrosis incidence of 11% to 44% remains a major complication. Previous clinical studies have shown that maintaining the extrinsic vascular pathway (EVP) can increase the survival area of extended flaps. The authors hypothesized that preserving the EVP would improve flap survival by reducing blood resistance within the vascular territory.