Department of Plastic Surgery, Helsinki University Hospital, Helsinki, Finland.
J Reconstr Microsurg. 2010 Feb;26(2):73-7. doi: 10.1055/s-0029-1242135. Epub 2009 Nov 9.
The purpose of this prospective study was to assess the blood flow of the radial and ulnar arteries before and after radial forearm flap raising. Twenty-two patients underwent radial forearm microvascular reconstruction for leg soft tissue defects. Blood flow of the radial, ulnar, and recipient arteries was measured intraoperatively by transit-time and ultrasonic flowmeter. In the in situ radial artery, the mean blood flow was 60.5 +/- 47.7 mL/min before, 6.7 +/- 4.1 mL/min after raising the flap, and 5.8 +/- 2.0 mL/min after end-to-end anastomosis to the recipient artery. In the ulnar artery, the mean blood flow was 60.5 +/- 43.3 mL/min before harvesting the radial forearm flap and significantly increased to 85.7 +/- 57.9 mL/min after radial artery sacrifice. A significant difference was also found between this value and the value of blood flow in the ulnar and radial arteries pooled together ( P < 0.05). The vascular resistance in the ulnar artery decreased significantly after the radial artery flap raising (from 2.7 +/- 3.1 to 1.9 +/- 2.2 peripheral resistance units, P = 0.010). The forearm has a conspicuous arterial vascularization not only through the radial and ulnar arteries but also through the interosseous system. The raising of the radial forearm flap increases blood flow and decreases vascular resistance in the ulnar artery.
本前瞻性研究旨在评估桡动脉和尺动脉在前臂桡侧游离皮瓣掀起前后的血流情况。22 例患者因小腿软组织缺损接受桡侧前臂显微血管重建。术中通过瞬态和超声流量计测量桡动脉、尺动脉和受区动脉的血流。在原位桡动脉中，皮瓣掀起前平均血流为 60.5 ± 47.7 mL/min，掀起后为 6.7 ± 4.1 mL/min，与受区动脉端端吻合后为 5.8 ± 2.0 mL/min。在尺动脉中，桡侧前臂游离皮瓣采集前平均血流为 60.5 ± 43.3 mL/min，桡动脉牺牲后显著增加至 85.7 ± 57.9 mL/min。与桡动脉和尺动脉血流值之和相比，该值也存在显著差异（P < 0.05）。桡动脉皮瓣掀起后尺动脉血管阻力显著降低（从 2.7 ± 3.1 到 1.9 ± 2.2 外周阻力单位，P = 0.010）。前臂不仅通过桡动脉和尺动脉，而且通过骨间系统具有明显的动脉血管化。桡侧前臂皮瓣的掀起增加了尺动脉的血流量并降低了血管阻力。
