Perfusion classification in a IR injury DIEP flap model peripheral border of zone III and in zone IV. PFL in the control group was observed in four of the seven animals. PFL was significantly increased in both IR injury groups (Figure 7.3). The percentages of PFL in IR injury I and IR injury II were 44±8.7% and 42±1.8%, respectively. PFL was comparable in the two IR injury groups. There was one case of total flap loss in the IR injury group II. Figure 7.3 Percentage of partial flap loss in relation of the whole flap is shown. We observed that all necroses in all study groups occurred in the peripheral parenchyma of the flaps. With IR injury, PFL was increased, and the area of necrosis was increasingly affected in a distal to central fashion. In the nonischemia group, PFL was observed solely in zone IV and incidentally in zone III (Figure 7.1). After induction of IR injury, however, PFL tended to occur in all zones of the flap compared with the sham group (Figure 7.4, Table 7.2). Figure 7.4 Typical partial flap loss in the study groups: (a) sham group, (b) IR injury I, (c) IR injury II. Note that partial flap loss is mostly present in zone IV and that the necrosis area increases from the peripheral border toward the center of the flap when the flap is subjected to IR injury. 105
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