AUTONOMIZATION OF EPIGASTRIC FLAPS IN RATS
AUTONOMIZATION OF EPIGASTRIC FLAPS IN RATS
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DOI：
10.1002/micr.20892
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发表时间：
2011-09-01
期刊：
影响因子：
2.1
通讯作者：
Wolff, Klaus-Dietrich
中科院分区：
文献类型：
--
作者：
Muecke, Thomas;Borgmann, Anna;Wolff, Klaus-Dietrich
从现有的文献中无法明确回答皮瓣依赖于其蒂多长时间的问题。为了解决这一问题，我们研究了创面中皮瓣坏死的时间以及皮瓣坏死减少到临床可忽略水平的时间长度。24只大鼠游离上腹部浅皮瓣。伤口愈合3、5、7或10天后，再次暴露蒂，结扎并分离。采用激光分光光度法无创测量血流量（flow）、流速（velocity）、血红蛋白水平（Hb）和血氧饱和度（SO2）。皮瓣坏死面积3天后为62.77 ± 1.71%，5天后为16.26 ± 0.86%，7天后为2.88 ± 0.14%，10天后为1.64 ± 0.16%（P <0.001）。Hb、血流和流速是术前和术后时间点发生皮瓣坏死的重要因素（P <0.0001），而SO2和血流是蒂结扎时坏死的重要预测因素（P <0.0001）。不同时间点之间的SO2（P <0.0001）、流量（P <0.0001）和流速（P = 0.001）的百分比变化是皮瓣坏死的显著预测因素。在该大鼠模型中，已发现在其伤口床中的血管化游离皮瓣的完全再分化所需的时间在术后第5天和第7天之间完成。皮瓣坏死的面积取决于不同时间点的SO2、Hb、血流和流速的当前值，但更重要的是，还取决于这些参数的围手术期变化。(C)2011 Wiley-Liss，Inc.显微外科31：472 - 478，2011年。
The question of how long a flap depends on its pedicle cannot be answered clearly from the available literature. To address this, we investigated the time to flap autonomization in the wound bed and the length of time to the point when flap necrosis is reduced to a clinically negligible level. The superficial epigastric flap was raised in 24 rats. After 3, 5, 7, or 10 days of wound healing, the pedicle was again exposed, ligated, and divided. Values of blood flow (flow), velocity (velocity), hemoglobin level (Hb), and oxygen saturation (SO2) were non-invasively measured using Laser spectrophotometry. The area of necrosis of the flap was 62.77 +/- 1.71% after 3 days, 16.26 +/- 0.86% after 5 days, 2.88 +/- 0.14% after 7 days, and 1.64 +/- 0.16% after 10 days (P < 0.001). Hb, flow, and velocity were found to be significant factors on developing flap necrosis at the preoperative and postoperative time point (P < 0.0001), whereas SO2 and flow were significant predictors of necrosis at the time of pedicle ligation (P < 0.0001). The percentage changes of SO2 (P < 0.0001), flow (P < 0.0001), and velocity (P = 0.001) between the different time points were significant predictors of flap necrosis. The time needed for the complete autonomization of vascularized free flaps in their wound beds has been found as completed between the 5th and 7th day postoperatively in this rat model. The area of flap necrosis depends on the present value of SO2, Hb, flow, and velocity at different time points, but, more importantly, also on the perioperative change of these parameters. (C) 2011 Wiley-Liss, Inc. Microsurgery 31:472-478, 2011.