Center of Breast Plastic and Reconstructive Surgery, Hospital of Plastic Surgery, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
J Reconstr Microsurg. 2012 Feb;28(2):111-8. doi: 10.1055/s-0031-1289162. Epub 2011 Oct 13.
Abdominal flaps have recently gained considerable popularity in breast reconstruction, and their importance and advantages have been widely accepted. Given the unreliability of the distal parts in these flaps and the advancement of microsurgery, many modifications and improvements have been made. To get a better understanding of these flaps, researchers have encouraged the search for a suitable flap model. The purpose of this study was to clarify the anatomical and physiological features of the transmidline abdominal flap model in pig. We included 16 white female Yorkshire pigs in this study. In six pigs, the vascular anatomy of the abdominal region was studied by multidetector row computed tomographic angiography and anatomic dissection. In the remaining 10 pigs, three kinds of transmidline abdominal flap models were established. The pigs were scanned on the abdominal flap to evaluate the perfusion zones after the true abdominal transmidline flap was created, and then they were sacrificed to determine the flap survival area 7 days after surgery. The results of the study were as follows. (1) The pig's deep inferior epigastric vessels were smaller than deep superior epigastric vessels both in length and diameters. (2) The deep superior epigastric artery always bifurcates into two groups; each group gives off five or six branches. (3) The superficial superior epigastric veins were present, while the superficial epigastric arteries were absent in all the animals included. (4) The linea alba abdominis was tough and lack of vascular structures. The average perfusion units were 197.0 ± 24.2, 103.2 ± 36.4, 138.8 ± 25.4, and 30.2 ± 11.8 from zone I to zone IV. All the flaps underwent partial necrosis. The flap survival area percentage was 85.9 ± 4.1%. The transmidline abdominal skin flap in pig is a reliable and true abdominal flap model for future physiological studies, especially the circulatory dynamics in transmidline abdominal flaps.
腹部皮瓣在乳房重建中最近得到了广泛的关注，其重要性和优势已被广泛认可。鉴于这些皮瓣远端的不可靠性和显微外科的进步，已经进行了许多改进和完善。为了更好地了解这些皮瓣，研究人员鼓励寻找合适的皮瓣模型。本研究的目的是阐明猪中线腹部皮瓣模型的解剖和生理特征。我们纳入了 16 头白色雌性约克夏猪。在 6 头猪中，通过多排螺旋 CT 血管造影和解剖学研究了腹部的血管解剖结构。在其余 10 头猪中，建立了三种中线腹部皮瓣模型。在创建真正的中线腹部皮瓣后，对猪的腹部皮瓣进行扫描，评估灌注区域，然后处死猪，在手术后 7 天确定皮瓣存活面积。研究结果如下：（1）猪的腹壁下深动脉比腹壁上深动脉在长度和直径上都小。（2）腹壁上深动脉总是分为两组，每组发出 5 到 6 个分支。（3）所有动物均存在腹壁浅静脉，但不存在腹壁浅动脉。（4）白线坚韧，缺乏血管结构。从区 I 到区 IV，平均灌注单位分别为 197.0 ± 24.2、103.2 ± 36.4、138.8 ± 25.4 和 30.2 ± 11.8。所有皮瓣均发生部分坏死。皮瓣存活率为 85.9 ± 4.1%。猪的中线腹部皮瓣是未来生理研究的可靠、真正的腹部皮瓣模型，特别是中线腹部皮瓣的循环动力学。
