Cold preservation of enteric free flaps : an experimental study

Enteric free flaps have proven to be useful in the reconstruction of the esophagus. This study was designed to determine whether cold preservation can prolong the ischemia time of enteric flaps from the distal small bowel. Adult mongrel dogs were anesthetized, and the abdomen was opened at the midline. Two 10-cm portions of the distal small bowel were identified and dissected out on a single pedicle. The bowel was then divided, and one segment was cooled with iced saline sponges while the second segment was not. The blood supply to both segments was then clamped. After 2 hours, the bowel was reanastomosed, and the cold segment was marked. Twenty-four hours later, the dogs were reanesthetized and given fluorescein and the bowel was then examined under the Woods lamp. Sections from both the warm ischemia and cold ischemia bowel were examined histologically. Results indicated that cooling the bowel can retard histologic changes that ischemia produces in the bowel.