Ghali Shadi, Butler Peter E M, Tepper Oren M, Gurtner Geoffrey C
London, United Kingdom; New York, N.Y.; and Stanford, Calif. From the Department of Plastic Surgery, Royal Free Hospital, University of London; Laboratory of Microvascular Research and Vascular Tissue Engineering, Institute of Reconstructive Plastic Surgery, New York University Medical Center; and Division of Plastic Surgery, Stanford University School of Medicine.
Plast Reconstr Surg. 2007 May;119(6):1735-1744. doi: 10.1097/01.prs.0000246384.14593.6e.
The technique of vascular delay has been used by plastic surgeons for nearly 500 years and has proven useful for reliably transferring tissue and allowing for a greater volume of tissue to be reliably harvested. Delay procedures are an essential plastic surgical tool for a variety of aesthetic and reconstructive procedures. Despite the widespread use of vascular delay procedures, the mechanism by which this phenomenon occurs remains unclear. A number of groups have exhaustively examined microvascular changes that occur during vascular delay. Theories have been proposed ranging from the dilation of choke vessels to changes in metabolism and new blood vessel formation. Inherent in these theories is the concept that ischemia is able to act as the primary stimulus for vascular changes. The purpose of this review is to revisit the theories proposed to underlie the delay phenomenon in light of recent advances in vascular biology. In particular, the participation of bone marrow-derived endothelial progenitor cells in the delay phenomenon is explored. Greater understanding of the role these cells play in new blood vessel formation will be of considerable clinical benefit to high-risk patients in future applications of delay procedures.
血管延迟技术已被整形外科医生使用了近500年，并且已证明其在可靠地转移组织以及允许更大量的组织被可靠获取方面是有用的。延迟手术是用于各种美容和重建手术的重要整形外科工具。尽管血管延迟手术被广泛使用，但这种现象发生的机制仍不清楚。许多研究小组已经详尽地研究了血管延迟期间发生的微血管变化。已经提出了从阻塞血管扩张到代谢变化和新血管形成等各种理论。这些理论的内在概念是缺血能够作为血管变化的主要刺激因素。这篇综述的目的是根据血管生物学的最新进展重新审视为延迟现象提出的理论。特别是，探讨了骨髓来源的内皮祖细胞在延迟现象中的参与情况。更深入地了解这些细胞在新血管形成中所起的作用，将对高危患者在未来延迟手术的应用中带来相当大的临床益处。
