Preliminary Exploration: When Angiosome Meets Prefabricated Flaps
Preliminary Exploration: When Angiosome Meets Prefabricated Flaps
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DOI：
10.1055/s-0036-1585468
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发表时间：
2016-07
影响因子：
2.1
通讯作者：
Heng Xu;Zheng Zhang;Yimeng Xia;Zvi Steinberger;P. Min;Hua Li;Yahui Dai;Yixin Zhang
中科院分区：
文献类型：
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作者：
Heng Xu;Zheng Zhang;Yimeng Xia;Zvi Steinberger;P. Min;Hua Li;Yahui Dai;Yixin Zhang
摘要 背景 预制皮瓣使用中最为人知的局限是其存活面积有限。对此的一种解释是新生血管形成不足。然而，预制皮瓣的血流是通过其自身的血管网络。这可能会使人得出血管体区可能阻碍血液灌注的结论。本研究旨在解决理论与临床实践之间的这一矛盾。方法 我们在大鼠模型中进行了预制腹部皮瓣的两阶段手术。将大鼠分为五组（每组n = 6）。A组：水平角度固定蒂部；B组：斜角固定蒂部；C组：垂直角度固定蒂部；D组：与A组相同位置固定蒂部；E组：轴型皮瓣。A组和B组预制2周，C组和D组预制3周。记录宏观外观，并进行近红外荧光成像和毛细血管密度分析。结果 A组和B组皮瓣存活面积无显著差异。与C组相比，D组的存活面积显著更大。两个血管体区之间的边界（腹中线）似乎在B组、C组和E组中限制了吲哚菁绿灌注，而在A组和D组中未观察到这种限制。毛细血管密度与新生血管形成时间呈正相关。结论 血管体区阻碍预制皮瓣中的血液灌注。跨边界的新生血管滋养皮瓣，从而克服了 choke血管的局限。（注：“choke血管”可能是一种专业术语，如果有更准确的对应中文术语，请根据实际情况替换）
Abstract Background The best known limitation to the use of prefabricated flaps is their limited survival area. One explanation for this is insufficient neovascularization. However, blood flow of prefabricated flaps is through their innate vascular network. This could lead one to conclude that angiosomes may impede blood perfusion. This study aims to settle this contradiction between theory and clinical practice. Methods We performed a two-stage operation of a prefabricated abdominal flap in a rat model. The rats were divided into five groups (n = 6/group). Group A: fixed pedicle at a horizontal angle; Group B: fixed pedicle at an oblique angle; Group C: fixed pedicle at a vertical angle; Group D: fixed pedicle in the same position as Group A; and Group E: axial flap. Groups A and B were prefabricated for 2 weeks and Groups C and D were prefabricated for 3 weeks. Macroscopic appearance was noted, and analysis of near-infrared fluorescence imaging and capillary density was performed. Results There was no significant difference in the flaps' survival area between Groups A and B. Group D had a significantly larger survival area when compared with Group C. The boundary between two angiosomes (medioventral line) seemed to limit the indocyanine green perfusion in Groups B, C, and E, while in Groups A and D, no such limitation was seen. Capillary density was positively correlated with neovascularization time. Conclusions Angiosomes impede blood perfusion in prefabricated flaps. Cross-bound neovascular vessels nourish the flap, thus overcoming the limitation of choke vessels.