Germain M A, Vignot M, Gouget I, Luboinski B, Marandas P, Schwaab G, Hureau J, Trotoux J
Service de Chirurgie, Hôpital de Nanterre.
Chirurgie. 1991;117(8):597-601.
The use of vascularized, composite and prepared free transplants is a recent technique. Two types of transplants were grafted in rats (150 operated cases). For the prefabricated free transplants, each component remains vascularized by rami of the main pedicle: vessels, nerves, bone, periosteum, cartilage, muscle, skin (50 cases). The graft is transplanted immediately. Neovascularized free transplants are quite different, the various components being laid around the vascular pedicle (100 cases). Neovascularization revascularizes the components. The free graft is transplanted 5 weeks after being prepared. The period of observation ranges from 3 to 12 months. Observation includes macroscopy, arteriography, histology and intravascular dye injections. The results with prefabricated free transplants show normal vascularization of soft tissues. There is bone in all cases, it is normal in 80% of cases. In neovascularized transplants, the bone is normal in 33% of cases only, and totally resorbed in 46%. Prefabricated free transplants produce better results than neovascularized free transplants and must be preferred. The merit of these composite free transplants is that they produce free transplants selectively, using various tissues and chosen vascular pedicles. These transplants are a useful and futuristic alternative for highly sophisticated reconstructive surgery.
使用带血管的复合预制游离移植是一项新技术。在大鼠身上进行了两种类型的移植手术（共150例手术病例）。对于预制游离移植，每个组件都由主蒂的分支血管供血：血管、神经、骨骼、骨膜、软骨、肌肉、皮肤（50例）。移植片立即进行移植。新生血管化游离移植则完全不同，各种组件围绕血管蒂排列（100例）。新生血管化使各组件重新获得血供。游离移植片在制备后5周进行移植。观察期为3至12个月。观察内容包括大体检查、动脉造影、组织学检查和血管内染料注射。预制游离移植的结果显示软组织血管化正常。所有病例均有骨组织，其中80%的病例骨组织正常。在新生血管化移植中，只有33%的病例骨组织正常，46%的病例骨组织完全吸收。预制游离移植比新生血管化游离移植效果更好，应优先选择。这些复合游离移植的优点在于，它们利用各种组织和选定的血管蒂有选择地进行游离移植。这些移植对于高度复杂的重建手术是一种有用且具有前瞻性的替代方法。
