Ozcan G, Shenaq S, Baldwin B, Spira M
Microsurgery Research Laboratory, Baylor College of Medicine, Houston, Tex.
Plast Reconstr Surg. 1991 Aug;88(2):250-8. doi: 10.1097/00006534-199108000-00013.
The effect of suction-assisted lipectomy on cutaneous blood vessels of inguinal skin flaps was studied and compared in 191 rats. Different types of cannula tips were used; the number of passes was standardized. In one experiment, following suctioning, 3 X 2 cm groin island flaps based on inferior epigastric pedicles were raised and then reattached. Fluorescein dye study and microangiography were performed to evaluate flap viability. Flap survival was determined clinically and by histologic examination on the fifth postoperative day. Three-sided inguinal random-pattern flaps were raised in a second experiment and reattached following suctioning. On the fifth postoperative day, surviving flap areas were measured using standard photographs and an imaging computer and were compared with controls. Results showed that cannula passes accompanied by vacuum are harmful to vessels, while those unaccompanied by vacuum are not. The greater the number of suctioning passes, the more trauma there is to vessels and the greater is the likelihood of flap necrosis. Conical and spatula tips were more harmful to vessels than spherical, cobra, keel cobra, or Fournier tips. These results support the conclusion that suction-assisted lipectomy enhances the possibility of skin necrosis by traumatizing the vascular pedicle of a flap, especially when it is used as an adjunct to flap elevation.
在191只大鼠身上研究并比较了抽脂术对腹股沟皮瓣皮肤血管的影响。使用了不同类型的套管尖端；穿刺次数进行了标准化。在一项实验中，抽脂后，掀起以腹壁下血管为蒂的3×2厘米腹股沟岛状皮瓣，然后再进行缝合。进行荧光素染料研究和微血管造影以评估皮瓣的存活情况。在术后第5天通过临床检查和组织学检查确定皮瓣存活情况。在第二项实验中，掀起三边腹股沟随机皮瓣，抽脂后再进行缝合。在术后第5天，使用标准照片和成像计算机测量存活皮瓣面积，并与对照组进行比较。结果表明，伴有负压的套管穿刺对血管有害，而不伴有负压的则无害。抽脂穿刺次数越多，对血管的创伤越大，皮瓣坏死的可能性就越大。锥形和刮铲形尖端对血管的危害比球形、眼镜蛇形、龙骨眼镜蛇形或弗氏尖端更大。这些结果支持这样的结论，即抽脂术通过损伤皮瓣的血管蒂增加了皮肤坏死的可能性，尤其是当它作为皮瓣掀起的辅助手段时。
