Jiao S Y, Guo E T
Department of Plastic Surgery, Changhai Hospital, Second Military Medical University, Shanghai.
Zhonghua Zheng Xing Shao Shang Wai Ke Za Zhi. 1992 Sep;8(3):213-5, 249.
A comparative study of skin flap with a preserved subcutaneous vascular network and conventional skin flap was undertaken in rats with determination of skin temperature, laser Doppler, ink perfusion, microangiography and transparent specimen technics. It was found that all the skin flaps with a preserved subcutaneous vascular network survived after transplantation. Three hours postoperation, the flap microcirculation was poorest (LDF, 28% of the preoperative value). Six hours postoperation, it began to augment, and microvessels containing ink could be seen under microscope at 24 hours, as compared to 3 days postoperation in the controls. On the fifth day, LDF returned to the preoperative level, and the diameter and density of reformed microvessels were similar to the vessels of the adjacent skin. This phenomenon only occurred on the 7th day in the controls. After division of the pedicle on the fifth day, all the flaps survived, while the controls showed partial necrosis. The results indicate that skin flaps with a preserved subcutaneous vascular network can survive on the blood flow of pedicle in the early stage, at 24 hours postoperation flap microvessels begin to reform, and on the fifth day flaps can survive on the reformed microcirculation in spite of the severance of the pedicle.
在大鼠身上对保留皮下血管网的皮瓣和传统皮瓣进行了比较研究，采用皮肤温度测定、激光多普勒、墨水灌注、微血管造影和透明标本技术。结果发现，所有保留皮下血管网的皮瓣移植后均存活。术后3小时，皮瓣微循环最差（激光多普勒血流仪测定值为术前值的28%）。术后6小时，微循环开始改善，术后24小时在显微镜下可见含墨水的微血管，而对照组在术后3天可见。术后第5天，激光多普勒血流仪测定值恢复到术前水平，新生微血管的直径和密度与相邻皮肤的血管相似。这种现象在对照组中第7天才出现。术后第5天切断蒂部后，所有皮瓣均存活，而对照组出现部分坏死。结果表明，保留皮下血管网的皮瓣在早期可依靠蒂部血流存活，术后24小时皮瓣微血管开始重建，术后第5天即使切断蒂部，皮瓣也可依靠重建的微循环存活。
