Long‐term morphometric and immunohistochemical findings in human free microvascular muscle flaps
Long‐term morphometric and immunohistochemical findings in human free microvascular muscle flaps
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DOI：
10.1002/micr.10189
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发表时间：
2004
期刊：
影响因子：
2.1
通讯作者：
M. Kauhanen;F. Lorenzetti;I. Leivo;E. Tukiainen;S. Asko-Seljavaara
中科院分区：
文献类型：
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作者：
M. Kauhanen;F. Lorenzetti;I. Leivo;E. Tukiainen;S. Asko-Seljavaara
手术后 3-4 年，对 13 名移植到上肢或下肢的患者进行了手术未神经恢复的游离微血管肌皮瓣，研究了神经恢复、肌肉再生、微血管密度和肌肉类型特异性萎缩。对 PGP 9.5 和 S-100（神经元标记）、Ki-67（细胞增殖）、肌球蛋白（肌纤维类型）和 CD-31（内皮）进行常规组织学和免疫组织化学，并对结果进行形态计量学分析。术后3至4年，9例出现以慢型纤维为主的严重萎缩。 4 例肌纤维直径和纤维类型分布接近正常。术中长期肌肉缺血和术后固定与皮瓣肌肉体积较差有关。皮瓣中微血管的密度与对照肌肉没有差异。 7 名患者检测到 PGP 9.5 和 S-100 免疫阳性神经纤维。神经再支配与良好的肌肉体积相关。在 4 名患者中，卫星细胞的激活是明显的。结果表明，在某些情况下，游离肌皮瓣可能会发生自发的神经支配，并且在微血管游离皮瓣转移几年后，肌肉仍会尝试再生。 © 2004 Wiley-Liss, Inc.
Reinnervation, muscle regeneration, density of microvessels, and muscle‐type specific atrophy were studied 3–4 years after surgery in surgically nonreinnervated free microvascular muscle flaps to 13 patients transplanted to the upper or lower extremities. Routine histology and immunohistochemistry for PGP 9.5 and S‐100 (neuronal markers), Ki‐67 (cell proliferation), myosin (muscle fiber types), and CD‐31 (endothelium) were carried out, and results were analyzed morphometrically. Three to 4 years after surgery, severe atrophy of predominantly slow‐type fibers was seen in 9 cases. In 4 cases, muscle‐fiber diameter and fiber‐type distribution were close to normal. Long intraoperative muscle ischemia and postoperative immobilization were associated with poor muscle bulk in flaps. The density of microvessels in flaps did not differ from control muscles. PGP 9.5 and S‐100 immunopositive nerve fibers were detected in 7 patients. Reinnervation was associated with good muscle bulk. In 4 patients, activation of satellite cells was evident. The results suggest that in some cases, spontaneous reinnervation may occur in free muscle flaps, and that several years after microvascular free flap transfer, the muscle still attempts to regenerate. © 2004 Wiley‐Liss, Inc.