Persistence of pedicle blood flow up to 10 years after free musculocutaneous tissue transfer
Persistence of pedicle blood flow up to 10 years after free musculocutaneous tissue transfer
复制标题
DOI：
10.1097/00006534-199803000-00021
复制
发表时间：
1998-03-01
影响因子：
3.6
通讯作者：
Berger, A
中科院分区：
文献类型：
--
作者：
Machens, HG;Pallua, N;Berger, A
对游离组织移植后皮瓣的血管蒂灌注能否持续10个梨的假设进行了检验。自1982年以来，该机构已经进行了1000多例免费组织移植。其中，选择了40例具有类似的创伤后下肢软组织缺损并通过背阔肌游离皮瓣进行手术修复的患者。所有患者术后无并发症。第1 ~ 4组（每10例）3 ~ 5周，5 ~ 6周开始测量皮瓣灌注。分别为游离组织移植后的几个月、4至6年和8至10年。通过氢清除技术（Ameda，瑞士）在皮瓣皮肤叶片内的皮内和皮下的特定部位以及邻近的皮内和周围软组织的皮下技能进行局部皮瓣灌注的定量测量。同时，用双工扫描仪（Toshiba, Japan）观察皮瓣的血管蒂。在每一组中，在A期之前、B期期间和C期结束后分别进行9次测量。每次测量大约需要10分钟。通过Mann-Whitney U检验和Wilcoxon符号秩检验对所得值进行统计评价。四组患者A期和C期局部皮瓣灌注无统计学差异。然而，在B期，四组皮瓣皮肤桨叶部位局部皮瓣灌注缺失具有高度统计学意义（p < 0.01）。周围软组织的皮内和皮下血流量没有统计学意义的改变。在我们的临床实验环境中，在游离组织移植后10年，皮瓣的血流灌注通过血管蒂持续存在。我们的研究结果支持完整的血管蒂对游离组织移植后永久皮瓣存活的重要性。
The hypothesis of whether or not flap perfusion remains persistent through its vascular pedicle up to 10 pears after free tissue transfer was tested. Since 1982, more than 1,000 free tissue transfers have been performed at this institution. Of these, 40 patients were selected with comparable posttraumatic soft-tissue defects of the lower leg and surgical repair by a latissimus dorsi myocutaneous free flap. All patients had a postoperative course free of complications. Measurements of flap perfusion were started in groups 1 through 4 (each 10 patients) 3 to 5 weeks, 5 to ? months, 4 to 6 years, and 8 to 10 years after free tissue transfer, respectively. Quantitative measurements of local flap perfusion were performed by means of the hydrogen clearance technique (Ameda, Switzerland) at definite sites intracutaneously and subcutaneously within the flap's skin paddle as well as in the adjacent intracutaneous and subcutaneous skill of the surrounding soft tissue. Simultaneously, the vascular pedicle of the flap was visualized by a duplex scanner (Toshiba, Japan). In each group nine measurements were performed before (phase A), during (phase B), and after closing the pedicle (phase C) by manual compression. Each measurement took about 10 minutes. Statistical evaluation of the obtained values was achieved by the Mann-Whitney U test and the Wilcoxon signed rank test. Local flap perfusion showed no statistical differences for phase A and C in all four groups of patients. In phase B, however, a statistically highly significant (p < 0.01) absence of local flap perfusion was registered in all four groups at the site of the flap's skin paddle. No statistically significant alterations of intracutaneous and subcutaneous blood flow was found in the surrounding soft tissue. In our clinical-experimental setting, flap perfusion persisted by means of its vascular pedicle even 10 years after free tissue transfer. Our findings support the importance of an intact vascular pedicle for permanent flap survival after free tissue transfer.