Background/purpose: To construct a musculo-peritoneal flap adequately vascularised through attached omentum and to evaluate whether this flap is functional for growing new intestinal mucosa.
Methods: 24 rats underwent two surgical procedures. 1) A musculo-peritoneal flap was prepared, omentum was fixed onto the muscular side and a silicon graft was placed on the peritoneal side. 2) After one month the so constructed OPMP flap was mobilised and attached to the jejunum. Animals were harvested at 2, 4 and 8 months for macroscopic and microscopic evaluation.
Results: One rat died at 7 months due to intestinal volvulus. In the remainder the circumference of the patched intestine significantly increased compared to that of normal intestine (p<0.001). The flaps were markedly contracted in the 4 month rats (p<0.01). All flaps were completely covered by neomucosa except in the 2 month rats. Crypt depth and crypt density of the neomucosa was significantly lower in 2 month rats compared to other groups (p<0.05). Similarly neomucosal villous height was markedly low in the 2 month rats (p<0.01).
Conclusions: To date, we have found no reports of small bowel patching using this technique. In this context, use of OPMP flap is likely to be useful for increasing intestinal surface area.