• José A González-García, Carlos M Chiesa-Estomba, Leire Álvarez, Xabier Altuna, Leire García-Iza, Izaskun Thomas, Jon A Sistiaga, and Ekhiñe Larruscain.
• Head and Neck Surgery and Reconstructive Section, Otorhinolaryngology and Head and Neck Surgery Department, Hospital Universitario Donostia, Donostia-San Sebastián, Spain. Electronic address: joseangel.gonzalezgarcia@osakidetza.eus.
• J. Surg. Res. 2018 Jul 1; 227: 81-87.

BackgroundPerforator free flap-based reconstruction of the head and neck is a challenging surgical procedure and needs a steep learning curve. A reproducible mammal large animal model with similarities to human anatomy is relevant for perforator flap raising and microanastomosis. The aim of this study was to assess the feasibility of a swine model for perforator-based free flaps in reconstructive microsurgery.MethodsEleven procedures were performed under general anesthesia in a porcine model, elevating a skin flap vascularized by perforating musculocutaneous branches of the superior epigastric artery to evaluate the relevance of this model for head and neck reconstructive microsurgery.ResultsThe anterior abdominal skin perforator-based free flap in a swine model irrigated by the superior epigastric artery was elevated in eleven procedures. In six of these procedures, we could perform an arterial and venous microanastomosis to the great vessels located in the base of the neck.ConclusionsThe porcine experimental model of superior epigastric artery perforator-based free flap reconstruction offers relevant similarities to the human deep inferior epigastric artery perforator flap. We could demonstrate this model as acceptable for perforator free flap training due to the necessity of perforator and pedicle dissection and transfer to a distant area.Copyright © 2018 Elsevier Inc. All rights reserved.

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