The research in prevention of partial flap necrosis has recently concentrated on extending the safe length of a flap by ligating vessels of known territories rather than dividing vessels randomly by elevating the flap. In order to advance this approach one step further, we decided to investigate if selective desiccation of these pedicles with percutaneous radiofrequency (RF) after identification with the Doppler probe would offer a simple but effective surgical means for strategic transfer of angiosomes.

The study was conducted as three ensuing experiments and involved a total number of 44 rabbits. We first developed a cutaneous island flap model spanning four adjacent vascular territories in a succeeding manner, each of which has a well-defined single vascular source. Then, by using this flap model, we tested the possibility of desiccating those vessels supply the angiosomes to be captured percutaneously with radiofrequency. Finally, we compared the effectiveness of selective interference of these pedicles to minimize the number of target vessels for successful transfer of angiosomes.

Percutaneous desiccation of the perforators with RF was found to be a reliable method comparable to ligation of the vessels under direct vision. Both techniques augmented the flap viability to approximately 95% from 63% of the flap without delay, confirming the utility of the new flap model. Furthermore, selective desiccation of the perforator(s) was as efficient as destruction of all vascular sources other than the pedicle.

An alternative flap model is introduced for future investigation of vascular delay process to augment flap survival. Using this flap, it was revealed that percutaneous desiccation of the perforators with RF would be an alternative means for transfer of angiosomes and that selective desiccation of these perforators(s) as a minimally invasive, easy to perform method would further promote strategic transfer of angiosomes.