Effect of recipient arterial blood inflow on free flap survival area
Effect of recipient arterial blood inflow on free flap survival area
复制标题
DOI：
10.1097/01.prs.0000299185.32881.55
复制
发表时间：
2008-02-01
影响因子：
3.6
通讯作者：
Harii, Kiyonori
中科院分区：
文献类型：
--
作者：
Miyamoto, Shimpei;Minabe, Toshiharu;Harii, Kiyonori
背景：采用不同的受区动脉对游离皮瓣成活面积的影响还没有很好的研究。作者的目的是目前的研究是比较游离皮瓣转移到不同受体动脉与不同的血流量的存活面积，并探讨在皮瓣的血管结构的变化。此三区皮瓣是以胸背血管为基础，解剖出腋血管。第1组为对照组，钳夹缺血60 min后将皮瓣转移至腹部皮肤缺损处。第2组（n = 24）和第3组（n = 24）是转移到不同受体血管的游离皮瓣模型。第2组将腋血管与颈总动脉和颈外静脉吻合，第3组将腋血管与股血管吻合。在第5天，评估皮瓣的存活面积，全身血管造影，并测量动脉流入皮瓣performed.Results：最大的平均皮瓣存活率被认为是在第2组（94.3%）。第1组和第2组以及第2组和第3组之间的差异具有统计学显著性。血管造影结果显示，第二组的第二扼流区广泛扩张，而第一组和第三组的第二扼流区仅轻微扩张或保持不开放。结论：结果表明，增加动脉流入的游离皮瓣可以打开第二扼流区，提高皮瓣成活面积。
Background: The influence of using different recipient arteries on free flap survival area has not been well studied. The purpose of the authors' present study was to compare the survival areas of free flaps transferred to different recipient arteries with different blood inflow and to investigate the vascular structural changes in the flaps.Methods: The authors developed a free three-territory flap model on the back of a rat. This three-territory flap was elevated based on the thoracodorsal vessels, which were dissected to the axillary vessels. In group 1, the control group (n = 16), the flap was transferred to the abdominal skin defect as a pedicled flap after 60 minutes of clamp ischemia. Groups 2 (n = 24) and 3 (n = 24) were free flap models that were transferred to different recipient vessels. The axillary vessels were anastomosed to the common carotid artery and the external jugular vein in group 2, and to the femoral vessels in group 3. On day 5, evaluation of the survival area of the flap, whole-body angiography, and measurement of arterial inflow to the flap were performed.Results: The greatest mean flap survival was seen in group 2 (94.3 percent). The differences between groups 1 and 2 and groups 2 and 3 were statistically significant. Angiographic studies demonstrated that the second choke zone in group 2 dilated extensively, but in groups 1 and 3, the second choke zone dilated only slightly or remained unopened.Conclusion: The results suggest that augmenting the arterial inflow of a free flap could open the second choke zone and improve flap survival area.