Akyürek Mustafa, Sönmez Erhan, Ozkan Omer, Safak Tunç, Keçik Abdullah
Department of Plastic and Reconstructive Surgery, Hacettepe University Medical School, Sihhiye 06100, Ankara, Turkey.
Ann Plast Surg. 2002 Jun;48(6):654-9. doi: 10.1097/00000637-200206000-00015.
In this report the authors describe a new method that avoids autocannibalization by free transfer of a flap to the dorsum of the rat by means of a simple exposure technique. A total of 22 Wistar rats of both sexes (weight, 200-290 g) were used in this experiment. An anatomic study performed in 12 rats revealed that a wide exposure could be created in the axillary fossa by retracting the inferior tip of the scapular bone superiorly (after severing its attachments with the deep extrinsic back muscles), the latissimus dorsi muscle laterally, and the serratus anterior muscle medially. Furthermore, after obtaining vessel diameter measurements, it was ascertained that the subscapular and the lateral thoracic vessels could serve as the recipient vessels. Based on the anatomic study, a total of 10 conventional groin cutaneous flaps, measuring 2 x 3 cm in size, were harvested based on the femoral vessels and transferred to the dorsum of the same animal by the exposure method as just described, with microvascular anastomoses performed between the femoral vessels of the flap and either the subscapular artery and the lateral thoracic vein (N = 5) or the lateral thoracic artery and vein (N = 5). Results showed that 9 of the 10 transplanted flaps were totally viable on postoperative day 7, giving a success rate of 90%, with one failing flap belonging to the latter group. The authors conclude that by this simple method of recipient vessel exposure in the axillary fossa, free flap transfer to the dorsum of the rat is a simple and reproducible technique by microvascular anastomoses performed between the pedicle vessels of a flap and the subscapular artery and the lateral thoracic vein. This model offers the unique advantage of a dorsally located flap that is protected by autocannibalization. Moreover, daily observation and monitoring of the flap are easy and practical without the need to have the animal wear protective material such as vest.
在本报告中,作者描述了一种新方法,该方法通过一种简单的暴露技术将皮瓣自由转移至大鼠背部,从而避免自体蚕食。本实验共使用了22只雌雄皆有的Wistar大鼠(体重200 - 290克)。对12只大鼠进行的解剖学研究表明,通过将肩胛骨头的下端向上牵拉(切断其与背部深层外在肌肉的附着后)、背阔肌向外牵拉以及前锯肌向内牵拉,可在腋窝形成广泛的暴露。此外,在获得血管直径测量数据后,确定肩胛下血管和胸外侧血管可作为受区血管。基于解剖学研究,共切取10个大小为2×3厘米的传统腹股沟皮瓣,以股血管为蒂,通过上述暴露方法转移至同一动物的背部,并在皮瓣的股血管与肩胛下动脉和胸外侧静脉(N = 5)或胸外侧动静脉(N = 5)之间进行微血管吻合。结果显示,10个移植皮瓣中有9个在术后第7天完全存活,成功率为90%,其中一个失败皮瓣属于后一组。作者得出结论,通过腋窝受区血管的这种简单暴露方法,将游离皮瓣转移至大鼠背部是一种通过皮瓣蒂血管与肩胛下动脉和胸外侧静脉之间进行微血管吻合的简单且可重复的技术。该模型具有位于背部的皮瓣受自体蚕食保护的独特优势。此外,无需给动物穿戴背心等保护材料,即可轻松且实际地对皮瓣进行每日观察和监测。