Rickard R F, Wilson J, Hudson D A
Department of Plastic Surgery, University of Cape Town, Cape Town, Republic of South Africa.
Lab Anim. 2009 Oct;43(4):350-6. doi: 10.1258/la.2009.0080097. Epub 2009 Jun 8.
Microsurgical autotransplantation of tissues is employed clinically to reconstruct defects following burns, trauma and surgical cancer ablation, and to correct congenital abnormalities. Transplant vessels of <3 mm are anastomosed by hand under the microscope. Experimentally, anastomotic patency rates decrease with increasing vessel diameter mismatch, and clinically, ratios of 3:1 or greater lead to unacceptably low arterial patency rates. A number of surgical techniques for dealing with size mismatch are described, but no one method has found favour, and few controlled studies of technique are reported. In this report, a rodent superficial caudal epigastric artery (SCEA)/femoral artery (FA) model for the study of these techniques is described in detail. The diameter ratio between these vessels lies in the clinically relevant range of 1:1.5-1:2.5. In the male Wistar rat, external vessel diameters were not found to increase markedly in size between animal weights of 300 and 500 g. The length of FA distal to the origin of the SCEA, which is important in allowing undisturbed distal run-off, was found to be negatively associated with animal body weight, implying that a smaller animal would be better for this model. Mean femoral arterial flow rate, measured by transit-time ultrasound, was noted to be statistically and physiologically significantly higher in the right artery when compared with the left. This model has advantages over interposition vein graft models in that it minimizes vessel compliance mismatch, and avoids the need for a second anastomosis.
组织的显微外科自体移植在临床上用于修复烧伤、创伤和外科癌症切除术后的缺损,以及矫正先天性畸形。直径小于3毫米的移植血管在显微镜下手工进行吻合。在实验中,随着血管直径不匹配程度的增加,吻合通畅率会降低,在临床上,3:1或更大的比例会导致动脉通畅率低至不可接受。已经描述了许多处理尺寸不匹配的手术技术,但没有一种方法受到青睐,并且很少有关于技术的对照研究报告。在本报告中,详细描述了一种用于研究这些技术的啮齿动物浅表尾侧腹壁动脉(SCEA)/股动脉(FA)模型。这些血管之间的直径比处于临床相关范围1:1.5 - 1:2.5。在雄性Wistar大鼠中,在体重300至500克之间,未发现外部血管直径有明显增加。在SCEA起源远端的FA长度对于保证不受干扰的远端血流很重要,发现其与动物体重呈负相关,这意味着较小的动物更适合该模型。通过渡越时间超声测量,发现右侧股动脉平均血流速率在统计学和生理学上均显著高于左侧。该模型相对于静脉移植模型具有优势,因为它最大限度地减少了血管顺应性不匹配,并避免了二次吻合的需要。