Dorion D, Boyd J B, Pang C Y
Division of Surgical Research, Hospital for Sick Children, Toronto, Ontario, Canada.
Plast Reconstr Surg. 1991 Oct;88(4):642-9. doi: 10.1097/00006534-199110000-00014.
The aim of this experiment was to design a clinically relevant TRAM flap in the pig and to use this flap model to study the effectiveness of preoperative ligation of the dominant vascular pedicle in augmentation of muscle and skin capillary blood flow and skin viability in the TRAM flap. This TRAM flap model was based on the deep inferior epigastric vascular pedicle, with the center of the transverse skin paddle attached to the underlying rectus abdominis muscle at the superior end of the muscle and extending bilaterally from its attached muscle. The transverse skin paddle (8 x 30 cm) included a contralateral and ipsilateral random portion of skin. This flap model was based on the deep inferior epigastric rather than the superior epigastric vascular pedicle because the deep inferior epigastric vascular pedicle is the smaller of the two in the pig and augmentation of its blood supply by ligation of the dominant superior epigastric vascular pedicle resembles more closely the clinical situation. It was observed that ligation of the dominant superior epigastric vascular pedicle 14 days prior to raising the TRAM flap significantly (p less than 0.05; n = 5) increased the total muscle and skin capillary blood flow and skin viability in the transverse skin paddle compared with the sham-operated control (n = 5).(ABSTRACT TRUNCATED AT 250 WORDS)
本实验的目的是在猪身上设计一种与临床相关的横行腹直肌肌皮瓣（TRAM瓣），并利用该瓣模型研究术前结扎主要血管蒂对增加TRAM瓣肌肉和皮肤毛细血管血流以及皮肤活力的有效性。该TRAM瓣模型基于腹壁下深血管蒂，横行皮瓣中心附着于腹直肌上端的下方肌肉，并从附着肌肉向两侧延伸。横行皮瓣（8×30厘米）包括对侧和同侧的随意皮区。该瓣模型基于腹壁下深血管蒂而非腹壁上血管蒂，因为在猪身上腹壁下深血管蒂较细，结扎主要的腹壁上血管蒂以增加其血供更接近临床情况。观察到在掀起TRAM瓣前14天结扎主要的腹壁上血管蒂，与假手术对照组（n = 5）相比，横行皮瓣的肌肉和皮肤毛细血管总血流量及皮肤活力显著增加（p < 0.05；n = 5）。（摘要截短于250字）
