It has been assumed, but never shown experimentally, that the survival of a free vascularized full‐thickness island flap is based on the vascular pedicle. A study using the rat was designed to assess the three parameters of flap survival: the vascular pedicle, the recipient bed, and the perimeter of the recipient area. Isolation of the pedicle by ligation caused flap necrosis in 18 out of the 20 groin flaps. An intact pedicle, with the other two parameters excluded, led to flap survival in 75% (9 of 12 flaps). Our results indicate that the critical factor to island flap survival in the immediate postoperative period is the vasculature supplying the pedicle. The two other factors are of limited importance.
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