Distal Arterialized Venous Supercharging Improves Perfusion and Survival in an Extended Dorsal Three-Perforasome Perforator Flap Rat Model
Distal Arterialized Venous Supercharging Improves Perfusion and Survival in an Extended Dorsal Three-Perforasome Perforator Flap Rat Model
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远端动脉化静脉增压可改善扩展背侧三穿孔体穿支皮瓣大鼠模型的灌注和生存
DOI：
10.1097/prs.0000000000007990
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发表时间：
2021-05
影响因子：
3.6
通讯作者：
Lin Damu
中科院分区：
文献类型：
--
作者：
Wu Hongqiang;Zhang Chenxi;Chen Zhengtai;Lou Junsheng;Ding Jian;Wang Long;Xie Chenglong;Gao Weiyang;Lin Damu
补充数字内容可在文本中找到。背景：穿支皮瓣通常用于各种皮肤缺损。许多策略（例如，高压氧和预处理）已被研究以提高皮瓣存活率，但术后2.03%至18.2%的皮瓣坏死频率仍然是主要并发症。作者假设远端动脉化静脉增压（DAVS）皮瓣手术可能改善扩展的三穿孔体穿支皮瓣大鼠模型的灌注和存活率，并在术中挽救皮瓣缺血。研究方法：将120只雄性Sprague-Dawley大鼠（200 ~ 300 g）分为胸背动脉（TDA）皮瓣组和DAVS皮瓣组（n = 60/组）。以TDA穿通体为基础，在TDA皮瓣上设计约11 × 2.5cm ~ 2的皮瓣。在TDA皮瓣的基础上设计DAVS皮瓣，并以旋髂深静脉为蒂，封闭大鼠尾动脉，使DAVS皮瓣增压。在术后1、3、6和12小时以及1、3、5和7天，比较灌注和血管造影。在第7天，使用组织学和Western印迹法评估皮瓣活力和血管生成。结果：DAVS皮瓣成活率为100%，TDA皮瓣成活率为81.93 ± 5.38%，P < 0.001。旋髂深动脉与TDA穿通体、阻塞区II与阻塞区I的血流量比均高于DAVS皮瓣（均P < 0.05）。血管造影定性显示，在DAVS皮瓣组中，阻塞区II中的阻塞血管扩张较早且广泛。DAVS皮瓣组的CD 34+血管（68.66 ± 12.53/mm 2对36.82 ± 8.99/mm 2; p < 0.001）和血管内皮生长因子蛋白水平（0.22 ± 0.03对0.11 ± 0.03; p < 0.001）显著增加。结论：DAVS手术可提高三穿支穿支皮瓣的存活率，可用于术中修复皮瓣缺血。在可能的临床采用重建手术之前，需要进一步的研究。
Supplemental Digital Content is available in the text. Background: Perforator flaps are commonly applied for a variety of skin defects. Many strategies (e.g., hyperbaric oxygen and preconditioning) have been investigated to improve flap survival, but a postoperative 2.03 to 18.2 percent flap necrosis frequency remains a major complication. The authors hypothesized that a distal arterialized venous supercharged (DAVS) flap procedure might improve perfusion and survival in an extended three-perforasome perforator flap rat model and rescue flap ischemia intraoperatively. Methods: One hundred twenty male Sprague-Dawley rats (200 to 300 g) were divided into the thoracodorsal artery (TDA) flap group and the DAVS flap group (n = 60 per group). An approximately 11 × 2.5-cm2 flap based on the TDA perforasome was designed in the TDA flap. A DAVS flap was designed based on the TDA flap and supercharged by anastomosing the rat caudal artery with the deep circumflex iliac vein. At postoperative times 1, 3, 6, and 12 hours and 1, 3, 5, and 7 days, perfusion and angiography were compared. On day 7, flap viability and angiogenesis were assessed using histology and Western blotting. Results: The DAVS flap showed a higher survival rate compared with the TDA flap (100 percent versus 81.93 ± 5.38 percent; p < 0.001). All blood flow ratios of deep circumflex iliac artery to TDA perforasome and of choke zone II to choke zone I were higher in the DAVS flap (all p < 0.05). Angiography qualitatively revealed that choke vessels in choke zone II dilated earlier and extensively in the DAVS flap group. CD34+ vessels (68.66 ± 12.53/mm2 versus 36.82 ± 8.99/mm2; p < 0.001) and vascular endothelial growth factor protein level (0.22 ± 0.03 versus 0.11 ± 0.03; p < 0.001) were significantly increased in the DAVS flap group. Conclusions: The DAVS procedure improves three-perforasome perforator flap survival and can be used for rescuing flap ischemia intraoperatively. Further study is needed before possible clinical adoption for reconstructive operations.
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影响因子：
3.6
作者：
HARASHINA, T;SAWADA, Y;WATANABE, S
通讯作者：
WATANABE, S
DOI：
10.1016/j.bjoms.2018.01.019
发表时间：
2018-05-01
影响因子：
1.8
作者：
Muecke, T.;Schmidt, L. H.;Ritschl, L. M.
通讯作者：
Ritschl, L. M.
影响因子：
3.6
作者：
Miyamoto, Shimpei;Minabe, Toshiharu;Harii, Kiyonori
通讯作者：
Harii, Kiyonori
影响因子：
3.6
作者：
Chang, Hak;Minn, Kyung Won;Nakajima, Hideo
通讯作者：
Nakajima, Hideo
影响因子：
1.9
作者：
Kong, Byeong Seon;Kim, Yong Jin;Lee, Sang Gil
通讯作者：
Lee, Sang Gil