Wenzhou and Shanghai, People's Republic of China From the Department of Orthopedics, Division of Plastic and Hand Surgery, Second Affiliated Hospital of Wenzhou Medical College; and Department of Orthopedics, The Sixth Affiliated People's Hospital, Shanghai Jiao Tong University.
Plast Reconstr Surg. 2013 Sep;132(3):372e-380e. doi: 10.1097/PRS.0b013e31829acf3d.
Flap prefabrication offers a bridging role between traditional reconstructive surgery and tissue engineering; however, because flap prefabrication is based on the concept of implanting a nourishing vascular pedicle in the target tissues before transfer, survival remains unreliable. Furthermore, the extended period required for neovascularization hampers its clinical application.
Based on two different venous angiosomes involving two sides of thoracoepigastric veins (taken as the vascular carrier) in rabbits, a large abdominal flap measuring 12 × 13 cm was designed by anastomosing the transferred femoral artery with the thoracoepigastric vein distally and prefabricated by incision of the proximal and distal ends of the flap for 1 week. Traditional arterial flaps, arterialized venous flaps, and composite skin grafts of the same size were used as control groups. Flap viability, status of vascular perfusion and microvasculature, and level of epidermal metabolite in each group were assessed.
The large prefabricated flaps achieved results similar to the traditional flaps in terms of flap viability, status of vascular perfusion and microvasculature, and level of epidermal metabolite.
Large skin flaps with good quality can be prefabricated within a shorter period for aesthetic and plastic surgery reconstruction using the inherent venous system. This technique may prove to be a viable alternative for successful flap prefabrication.
皮瓣预制在传统重建手术和组织工程之间起到了桥梁作用；然而，由于皮瓣预制基于在转移前将营养血管蒂植入靶组织的概念，因此其存活率仍然不可靠。此外，新生血管化所需的延长时间限制了其临床应用。
基于涉及兔胸腹壁静脉两侧的两个不同静脉血管分布区（作为血管载体），通过吻合转移的股动脉与胸腹壁静脉的远端，设计了一个 12×13cm 的大型腹部皮瓣，并通过皮瓣的近端和远端切口预制 1 周。将传统的动脉皮瓣、动脉化静脉皮瓣和相同大小的复合皮片作为对照组。评估每组皮瓣的存活情况、血管灌注和微血管状态以及表皮代谢物水平。
大型预制皮瓣在皮瓣存活、血管灌注和微血管状态以及表皮代谢物水平方面与传统皮瓣相似。
使用固有静脉系统，可在更短的时间内预制出具有良好质量的大型皮瓣，用于美容和整形重建。该技术可能成为成功皮瓣预制的可行替代方案。
