Porcine model for free-flap breast reconstruction training
Porcine model for free-flap breast reconstruction training
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DOI：
10.1016/j.bjps.2015.06.006
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发表时间：
2015-10-01
影响因子：
2.7
通讯作者：
Bruant-Rodier, Catherine
中科院分区：
文献类型：
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作者：
Bodin, Frederic;Diana, Michele;Bruant-Rodier, Catherine
背景：游离皮瓣乳房再造是一种具有挑战性的外科手术，具有陡峭的学习曲线。一个可重复的大型动物模型可能是相关的游离皮瓣收获和显微外科吻合训练。本研究的目的是评估猪模型的可行性，为自由皮瓣乳房reconstruct.Methods：三只雌性猪被放置在全身麻醉下，以研究可行性和估计相关的培训。分别切取腹壁下动脉穿支皮瓣、股薄肌横支皮瓣和臀上级动脉穿支皮瓣，并与胸廓内血管吻合。结果：在胸前壁较突出的情况下，胸廓内血管比人体解剖略深、略大，但在胸前壁较突出的情况下，胸廓内血管比人体解剖略深、略大。DIEP皮瓣从未在猪模型中可行。然而，上级腹壁动脉穿支（SEAP）皮瓣显示与人DIEP皮瓣解剖相似，并证明其适用于倒置训练模型。猪TMG皮瓣收获接近人类，重现特定的解剖和吻合困难。SGAP皮瓣在猪中不是肌穿支皮瓣，而是隔皮瓣。由于薄的皮下脂肪，猪皮瓣不被认为是足够的训练模型乳房丘shaping.Conclusions：尽管任何解剖变异，猪已被证明是一个合适的训练模型，自由皮瓣收获和转移在乳房重建领域。(C)2015年英国整形、重建和美容外科医生协会。由爱思唯尔有限公司出版。保留所有权利。
Background: Free-flap breast reconstruction is a challenging surgical procedure with a steep learning curve. A reproducible large animal model could be relevant for free-flap harvesting and microsurgical anastomosis training. The aim of this study was to assess the feasibility of a porcine model for free-flap breast reconstruction.Methods: Three female pigs were placed under general anesthesia in order to study feasibility and estimate relevance for training. The deep inferior epigastric perforator (DIEP) flap, the transverse musculocutaneous gracilis (TMG) flap, and the superior gluteal artery perforator (SGAP) flap were harvested and anastomosed to the internal thoracic vessels. Differences were noted between pig and human anatomy, and the surgical procedure was adapted to build training models.Results: Under a more prominent anterior thoracic wall, the internal thoracic vessels were slightly deeper and larger than in human anatomy. The DIEP flap was never feasible in the porcine model. However, the superior epigastric artery perforator (SEAP) flap showed anatomical similarity with the human DIEP flap, and it proved to be suitable for an inverted training model. The porcine TMG flap harvesting was close to the human one, reproducing specific dissection and anastomotic difficulties. The SGAP flap was not a muscular perforator flap in pigs but a septocutaneous flap. Because of the thinness of the hypodermal fat, porcine flaps were not considered adequate training models for breast-mound shaping.Conclusions: Despite any anatomical variations, the pig has proven to be a suitable training model for free-flap harvesting and transfer in the field of breast reconstruction. (C) 2015 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.