Ceylan Refika, Kaya Burak, Çaydere Muzaffer, Terzioğlu Ahmet, Aslan Gürcan
Department of Plastic, Reconstructive and Aesthetic Surgery, Gaziantep Dr. Ersin Arslan State Hospital , Gaziantep , Turkey.
J Plast Surg Hand Surg. 2014 Dec;48(6):368-74. doi: 10.3109/2000656X.2014.895741. Epub 2014 Mar 17.
The aim of the present study was to investigate the effect of ischaemic preconditioning compared with the surgical delay procedure in an effort to increase the survival rate of single pedicle island venous flaps. Eighteen male Wistar albino rats (250-350 g) were included. A 3 × 4 cm flap was planned at the right lower abdomen of the rat. Superficial epigastric vein constituted the pedicle of the flap. The rats were divided into three groups, each consisting of six rats. In the control group, a single pedicle venous island flap was elevated on each rat and no other surgical procedure was performed. In the ischaemic preconditioning group, ischaemic preconditioning was performed and, in the surgical delay procedure group, the surgical delay technique was performed before flap elevation. The mean necrosis areas were 56.85 ± 14.60%, 28.73 ± 15.60%, and 12.08 ± 3.65% in the control, ischaemic preconditioning, and surgical delay procedure groups, respectively. The necrosis areas were significantly smaller in the ischaemic preconditioning group and surgical delay procedure groups compared to the control group (p = 0.004 and p < 0.001, respectively). The necrosis areas were similar in the ischaemic preconditioning and surgical delay procedure groups. Histopathological parameters including necrosis, abscess formation, and skin ulceration scores were significantly lower in the ischaemic preconditioning group than in the control group, whereas the study groups were similar. In conclusion, ischaemic preconditioning may serve as an adjuvant technique in increasing venous island flap viability.
本研究的目的是调查缺血预处理与手术延迟程序相比，对提高单蒂岛状静脉皮瓣存活率的影响。纳入了18只雄性Wistar白化大鼠（250 - 350克）。在大鼠右下腹设计一个3×4厘米的皮瓣。腹壁浅静脉构成皮瓣的蒂。大鼠被分为三组，每组六只。对照组中，每只大鼠掀起一个单蒂静脉岛状皮瓣，不进行其他手术操作。在缺血预处理组中，进行缺血预处理；在手术延迟程序组中，在掀起皮瓣前进行手术延迟技术操作。对照组、缺血预处理组和手术延迟程序组的平均坏死面积分别为56.85±14.60%、28.73±15.60%和12.08±3.65%。与对照组相比，缺血预处理组和手术延迟程序组的坏死面积明显更小（分别为p = 0.004和p < 0.001）。缺血预处理组和手术延迟程序组的坏死面积相似。缺血预处理组的包括坏死、脓肿形成和皮肤溃疡评分在内的组织病理学参数明显低于对照组，而各研究组之间相似。总之，缺血预处理可作为提高静脉岛状皮瓣存活率的辅助技术。
