活化蛋白C（APC）对大鼠模型继发性静脉淤滞后游离腹股沟皮瓣的保护作用。

Protective effects of activated protein C (APC) on free groin flaps after secondary venous stasis in the rat model.

作者信息

Wallmichrath J, Knab R, Baumeister R G H, Holzbach T, Giunta R E, Frick A

机构信息

Hand Surgery, Plastic Surgery and Aesthetic Surgery, University Hospital of the Ludwig-Maximilians-University, Munich, Germany.

Consultant for Lymphology of the Surgical Clinic Munich Bogenhausen, Munich, Germany.

出版信息

Clin Hemorheol Microcirc. 2015;59(4):335-43. doi: 10.3233/CH-131803.

DOI:10.3233/CH-131803

PMID:24254581

Abstract

BACKGROUND

The goal of this study was to determine whether the focused delivery of APC by rinsing of free adipocutaneous groin flaps shows protective effects on flap survival following a fatal secondary venous stasis in a rat model.

METHODS

36 Sprague Dawley rats were randomized to three groups and free microvascular groin flaps were transplanted to the neck in each animal. 20 hours postoperatively the flap pedicle was re-explored and the distal stump of the flap artery was catheterised. Animals in group I (n = 12) remained untreated, whereas animals of group II were treated with 1 ml of Ringer's solution. Those in group III received 1 ml of APC (2 mg/kg). Afterwards the flap vein was clamped for 35 minutes. The skin of the flaps and the native contralateral groin was examined by intravital video microscopy using FITC-Dextran and CFDA-SE-labelled thrombocytes.

RESULTS

APC-pretreatment significantly increased the functional capillary density (FCD) of the flaps. Flap viability was 8% in group I (n = 1/12), 9% in group II (n = 1/11) and 60% in group III (n = 6/10), respectively. No partial flap loss was detected.

CONCLUSIONS

The focused delivery of APC resulted in significantly improved flap salvage.

摘要

背景

本研究的目的是确定在大鼠模型中，通过冲洗游离腹股沟脂肪皮瓣聚焦递送抗凝血酶（APC）是否对致命性继发性静脉淤滞后的皮瓣存活具有保护作用。

方法

将36只Sprague Dawley大鼠随机分为三组，每组动物均将游离微血管腹股沟皮瓣移植至颈部。术后20小时再次探查皮瓣蒂部，并将皮瓣动脉的远端残端插入导管。第一组（n = 12）的动物不接受治疗，而第二组动物用1毫升林格氏液治疗。第三组动物接受1毫升APC（2毫克/千克）。之后，将皮瓣静脉夹闭35分钟。使用异硫氰酸荧光素-葡聚糖（FITC-Dextran）和羧基荧光素二乙酸琥珀酰亚胺酯（CFDA-SE）标记的血小板，通过活体视频显微镜检查皮瓣和对侧腹股沟的皮肤。