Krakowczyk Lukasz, Maciejewski Adam, Szymczyk Cezary, Wierzgoń Janusz, Szumniak Ryszard, Jędrzejewski Piotr, Grajek Maciej, Dobrut Mirosław, Ulczok Rafał, Półtorak Stanisław
Department of Oncological and Reconstructive Surgery, Center of Oncology - Maria Sklodowska-Curie Institute of Oncology, Branch Gliwice, Poland.
Contemp Oncol (Pozn). 2012;16(6):546-50. doi: 10.5114/wo.2012.32488. Epub 2013 Jan 4.
The aim of the study was to develop standards for the prefabrication of free microvascular flaps in an animal model, followed by their application in clinical practice, and quantitative/qualitative microscopic assessment of the extent of development of a new microvascular network.
The study was carried out in 10 experimental pigs. As the first stage, a total of 20 prefabricated flaps were created using polytetrafluoroethylene (PTFE) as a support material, placed horizontally over an isolated and distally closed vascular pedicle based on superficial abdominal vessels. After completing the animal model study, one patient was selected for the grafting of the prefabricated free flap.
All 20 free flaps prefabricated in the animal model were analyzed microscopically, exhibiting connective tissue rich in fibroblasts and small blood vessels in the porous areas across the entire thickness of the PTFE element.
Flap prefabrication is a new and fast developing reconstruction technique. The usefulness of prefabrication techniques and their status in reconstructive surgery still needs to be investigated experimentally and clinically. The method based on prefabricated free flaps is the first step towards anatomical bioengineering that will make it possible to replace missing organs with their anatomically perfect equivalents.
本研究的目的是在动物模型中制定游离微血管皮瓣预制标准，随后将其应用于临床实践，并对新微血管网络的发育程度进行定量/定性显微镜评估。
本研究在10头实验猪身上进行。作为第一阶段，使用聚四氟乙烯（PTFE）作为支撑材料，共制作了20个预制皮瓣，将其水平放置在基于腹壁浅血管的孤立且远端封闭的血管蒂上。完成动物模型研究后，选择一名患者进行预制游离皮瓣移植。
对动物模型中预制的所有20个游离皮瓣进行了显微镜分析，结果显示在PTFE元件全层的多孔区域中存在富含成纤维细胞和小血管的结缔组织。
皮瓣预制是一种新的且快速发展的重建技术。预制技术的实用性及其在重建手术中的地位仍需通过实验和临床研究来探究。基于预制游离皮瓣的方法是走向解剖生物工程的第一步，这将使得用解剖学上完美的等效物替代缺失器官成为可能。
