Tan Maybelle P S, Lim Aymeric Y T, Zhu Qifen
Department of Hand and Reconstructive Microsurgery, National University Hospital, Singapore.
Microsurgery. 2009;29(3):226-31. doi: 10.1002/micr.20610.
Venous flaps have several potential advantages over traditional flaps, but their uses have been limited by unpredictable survival. Although clinical and experimental studies have concentrated mainly on the antegrade arterialization of venous flaps to increase survival, retrogradely arterialized venous flaps (AVFs) may have the greatest potential. There is, however, little literature on their use. There are also no animal studies comparing their survival to other venous flaps used in a similar situation. Our aim was to design a flap utilizing the rabbit's valved, thoracoepigastric vein (consisting of the lateral thoracic and epigastric veins) as the source vessel for the study of retrograde arterialized venous flaps (RAVFs). A pilot study (n = 10) to determine the survival of RAVFs was performed utilizing this animal model. Four flaps had complete survival at the end of our 2-week observational period. However, we also had four partial flap losses and two cases in which the entire flap was lost. An average survival area of 44.5% was observed. In conclusion, our designed rabbit thoracoepigastric RAVF is simple to apply and easily reproducible. It is the first animal flap adapted specifically for the study of RAVFs, and may be used for the further investigation of these flaps, which have shown unpredictable survival to date.
静脉皮瓣相对于传统皮瓣有几个潜在优势，但其应用因存活率不可预测而受到限制。尽管临床和实验研究主要集中在静脉皮瓣的顺行动脉化以提高存活率，但逆行动脉化静脉皮瓣（AVF）可能具有最大潜力。然而，关于其应用的文献很少。也没有动物研究将其存活率与在类似情况下使用的其他静脉皮瓣进行比较。我们的目的是设计一种皮瓣，利用兔的带瓣胸腹壁静脉（由胸外侧静脉和腹壁静脉组成）作为逆行动脉化静脉皮瓣（RAVF）研究的源血管。利用该动物模型进行了一项初步研究（n = 10）以确定RAVF的存活率。在我们为期2周的观察期结束时，有4个皮瓣完全存活。然而，我们也有4个皮瓣部分坏死，2个皮瓣全部坏死。观察到平均存活面积为44.5%。总之，我们设计的兔胸腹壁RAVF应用简单且易于重复。它是第一个专门为研究RAVF而设计的动物皮瓣，可用于对这些迄今为止存活率不可预测的皮瓣进行进一步研究。
