Yozgat, Ankara, Istanbul, and Karaman, Turkey; and Geneva, Switzerland From Plastic, Reconstructive, and Aesthetic Surgery Clinic, Yozgat State Hospital; Plastic, Reconstructive, and Aesthetic Surgery Clinic and Departments of Nuclear Medicine and Pathology, Ankara Research and Training Hospital; Department of Sociology, University of Geneva; Plastic, Reconstructive, and Aesthetic Surgery Clinic, Bakirkoy Dr. Sadi Konuk Research and Training Hospital; and Dermatalogy Clinic, Karaman State Hospital.
Plast Reconstr Surg. 2013 May;131(5):1024-1034. doi: 10.1097/PRS.0b013e3182879edf.
In a random pattern skin flap, distal flap necrosis occurs as a result of inadequate blood flow. Microneedling with a handheld roller device is a new treatment modality, especially for facial rejuvenation. In this study, the authors used microneedling to increase flap viability.
Forty adult male Sprague-Dawley rats were divided into two groups of 20. The study group was exposed to McFarlane flap elevation and repositioning. The microneedling procedure was performed four times: 3 days before, on the day of, and on the third and sixth days after surgery. The control group was only exposed to surgery. The skin flap necrosis area was measured on the seventh postoperative day topographically by digital imaging and scintigraphy. After determination of necrosis area, the amount of neovascularization and number of vascular structures within the papillary dermal layer were counted histopathologically.
The mean percentages of necrosis in the flap area as determined by the Digimizer analysis program were 37.51 ± 5.08 in the control group and 29.42 ± 7.37 in the study group. The mean percentages of flap necrosis of the control group and the study group as determined by radionuclide scintigraphy were 31.4 ± 4.1 and 22.8 ± 5.0, respectively. The comparison of flap necrosis percentages showed that the study group had significantly lower values (p < 0.001). Vessel counts in the study group also showed significant increase (p < 0.05).
The authors' study showed that the microneedling method applied directly on the flap could be a faster, safer, and more effective therapy modality to increase flap viability.
在随意皮瓣中,由于血流不足会导致远端皮瓣坏死。微针滚轮装置是一种新的治疗方法,尤其适用于面部年轻化。在这项研究中,作者使用微针滚轮来提高皮瓣的成活率。
40 只成年雄性 Sprague-Dawley 大鼠随机分为两组,每组 20 只。实验组暴露于 McFarlane 皮瓣提升和重新定位。微针滚轮处理共进行 4 次:术前 3 天、手术当天、术后第 3 天和第 6 天。对照组仅接受手术。术后第 7 天通过数字成像和闪烁扫描对皮瓣坏死区域进行地形学测量。在确定坏死面积后,通过组织病理学计数测量乳头真皮层内的新生血管数量和血管结构数量。
通过 Digimizer 分析软件确定的对照组和实验组皮瓣坏死面积的平均值分别为 37.51 ± 5.08%和 29.42 ± 7.37%。通过放射性核素闪烁扫描确定的对照组和实验组皮瓣坏死的平均值分别为 31.4 ± 4.1%和 22.8 ± 5.0%。两组皮瓣坏死率的比较显示,实验组的值明显较低(p < 0.001)。实验组的血管计数也显示出明显增加(p < 0.05)。
作者的研究表明,直接应用于皮瓣的微针滚轮方法可能是一种更快、更安全、更有效的增加皮瓣成活率的治疗方法。