The pig buttock flap model was used firstly, to compare changes in expanded axial skin flap area with control flaps prior to flap elevation and 3 or 4 months post-flap inset and, secondly, to compare the thickness of expanded and control flaps at elevation and for 3 to 6 months post-flap inset. Following 5 weeks' expansion and prior to elevation, the expanded tissue had gained a significant 63.3% mean increase in area compared with the control tissue (p < 0.01). Immediately post elevation and inset, the expanded flaps were still significantly larger than the control flaps by a mean 29.8% (p < 0.01) but had lost 56% of the original area gained. Little change in area occurred in the 3 months post-flap inset as the expanded flaps were still a mean 23.4% larger than the control (p < 0.01). Dermal and cellular non-keratinised epidermal layers thickened markedly in expanded skin compared to control skin. Following elevation and inset of the flaps, both dermis and epidermis thickened in expanded and control flaps.
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