Effect of venous superdrainage on a four-territory skin flap survival in rats
Effect of venous superdrainage on a four-territory skin flap survival in rats
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DOI：
10.1097/01.prs.0000260590.44798.9c
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发表时间：
2007-06-01
影响因子：
3.6
通讯作者：
Nakajima, Hideo
中科院分区：
文献类型：
--
作者：
Chang, Hak;Minn, Kyung Won;Nakajima, Hideo
背景：在之前的一份报告中，作者证明远端动脉增压在增加皮瓣存活率方面更有效。动脉增强在皮瓣手术中的好处是毋庸置疑的，但静脉超引流的效果仍然存在争议。本研究的目的是探讨静脉增强如何在大鼠不同的超引流位置产生更大的皮瓣存活面积。方法：采用作者自行研制的四区皮瓣。40只大鼠分为4组：1组，仅以旋髂深动静脉为皮瓣；2组，皮瓣与同侧腹壁下浅静脉超排；3组，皮瓣与对侧腹壁下浅静脉超排；第4组皮瓣与对侧旋髂深静脉超排。术后第4天，通过测量皮瓣坏死和存活面积来评估皮瓣。通过血管造影评估静脉增强术产生的血管变化。结果：与1组相比（平均皮瓣存活率为37.8% +/- 5.0%），超引流皮瓣组的皮瓣存活面积显著增大（2组为57.4% +/- 6.5%,p < 0.001； 3组为72.4 +/- 21.3%,p < 0.001； 4组为89.2 +/- 18.8%,p < 0.001）。血管造影评估的皮瓣显示扩张的窒息静脉之间的领土和扩张的静脉重新定位沿长轴皮瓣。结论：本研究表明，静脉增强术也能有效提高皮瓣存活率，远端手术比近端手术在动脉增压方面更有效。
Background: In a previous report, the authors demonstrated that distal arterial supercharging is more effective at increasing flap survival. There is no doubt of the benefit of arterial augmentation in flap surgery, but the effect of venous superdrainage is still controversial. The purpose of this study was to investigate how venous augmentation could generate larger flap survival areas with different superdrainage positions in rats.Methods: A four-territory skin flap, developed by the authors, was used. Forty rats were divided into four groups, as follows: group 1, flaps based only on the deep circumflex iliac artery and vein; group 2, flaps superdrained with the ipsilateral superficial inferior epigastric vein; group 3, flaps superdrained with the contralateral superficial inferior epigastric vein; and group 4, flaps superdrained with the contralateral deep circumflex iliac vein. On the fourth postoperative day, the flaps were assessed by measurements of necrosis and survival areas. Vascular changes produced by venous augmentation were evaluated angiographically.Results: Compared with group 1 (mean flap survival, 37.8 +/- 5.0 percent), the flap survival areas were significantly greater in the superdrainage flap groups (group 2, 57.4 +/- 6.5 percent, p < 0.001; group 3, 72.4 +/- 21.3 percent, p < 0.001, and group 4, 89.2 +/- 18.8 percent; p < 0.001). Angiographic assessment of the flaps revealed dilatation of the choke vein between the territories and reorientation of dilated veins along the long axes of the flaps.Conclusions: This study demonstrates that venous augmentation is also effective for increasing flap survival, and the distal procedure is more effective than the proximal procedure in arterial supercharging.