Fitzal F, Valentini D, Worseg A, Holle J, Redl H
Ludwig Boltzmann Institute for Clinical and Experimental Traumatology, Vienna, Austria.
J Reconstr Microsurg. 2001 Jan;17(1):59-67. doi: 10.1055/s-2001-12690.
Monitoring systems to measure flap survival are either invasive, touch the surface of the tissue, or have problems in reproducibility. The authors sought to determine the efficacy of a laser Doppler imaging (LDI) system to measure perfusion in a myocutaneous flap, by producing a two-dimensional picture of the flap without touching the surface. They compared total flap perfusion with perfusion in selected areas of interest after flap surgery. The perfusion in the left groin of Sprague-Dawley rats was measured before and after surface rubbing, skin injury, and during different lighting conditions. The perfusion of the epigastric flap before and over a period of 60 min after elevation was measured, and values were compared to pre-surgical values and to sham-operated animals. They determined the differences between single and running-suture techniques after flap surgery, as well as between venous and/or arterial occlusion. Surface rubbing, skin injury, and light influenced the LDI image. After flap elevation, total flap perfusion remained stable, while the distal area (area 8, n = 7) of the flap showed a statistically significant decrease in perfusion (71 +/- 5.9 vs. 92 +/- 9.5 percent perfusion units--PU; p < .05). The proximal areas (1 to 3, n = 7) of the flap had a higher perfusion at 60 min after flap surgery, compared with sham-operated (n = 8) animals (118 +/- 12.5 vs. 97 +/- 10.4 percent PU; p < .05). The running-suture technique was followed by decreased perfusion on the peripheral side of the flap, compared with the single-suture technique (73.7 +/- 9.2 vs. 99.2 +/- 4.9 percent PU; n = 2). The LDI was able to visualize venous and/or arterial occlusion after flap surgery. Under standardized circumstances (light, temperature), the LDI was efficient in measuring regional flap circulation experimentally. While total flap perfusion after flap surgery remained stable, perfusion in the distal flap decreased significantly.
用于测量皮瓣存活情况的监测系统要么具有侵入性，会接触组织表面，要么在可重复性方面存在问题。作者试图通过生成皮瓣的二维图像而不接触其表面，来确定激光多普勒成像（LDI）系统测量肌皮瓣灌注的效果。他们比较了皮瓣手术后皮瓣的总灌注量与选定感兴趣区域的灌注量。在表面摩擦、皮肤损伤前后以及不同光照条件下，测量了Sprague-Dawley大鼠左腹股沟的灌注情况。测量了上腹皮瓣掀起前及掀起后60分钟内的灌注情况，并将测量值与术前值以及假手术动物的值进行比较。他们确定了皮瓣手术后单缝合法与连续缝合法之间以及静脉和/或动脉闭塞之间的差异。表面摩擦、皮肤损伤和光照会影响LDI图像。皮瓣掀起后，皮瓣的总灌注量保持稳定，而皮瓣远端区域（区域8，n = 7）的灌注量在统计学上显著下降（灌注单位——PU分别为71±5.9和92±9.5；p <.05）。与假手术动物（n = 8）相比，皮瓣近端区域（1至3，n = 7）在皮瓣手术后60分钟时灌注量更高（PU分别为118±12.5和97±10.4；p <.05）。与单缝合法相比，连续缝合法会导致皮瓣外周侧的灌注量下降（PU分别为73.7±9.2和99.2±4.9；n = 2）。LDI能够显示皮瓣手术后的静脉和/或动脉闭塞情况。在标准化条件（光照、温度）下，LDI在实验中能有效地测量皮瓣局部循环情况。虽然皮瓣手术后皮瓣的总灌注量保持稳定，但皮瓣远端的灌注量显著下降。
