Ross Phillip E, Deleyiannis Frederic W-B
School of Medicine.
Department of Surgery, University of Colorado, Aurora.
Eplasty. 2015 Oct 6;15:e45. eCollection 2015.
Vascular steal has been cited to help explain end-organ ischemia after microvascular reconstruction. Attempts to clarify a mechanism of vascular steal have been made by modeling blood circulation after a simple electrical circuit, suggesting that the free flap provides a path of least resistance for blood flow and thereby compromises end-organ perfusion. We present a case of a posterior medial thigh perforator flap for the reconstruction of a diabetic foot ulcer in a patient with a single vessel providing inflow to the foot. In the context of this case, we provide a novel explanation for the steal phenomenon using the Hagen-Poiseuille law and the property of head loss in fluid dynamics and discuss how the vessel size of the free flap may contribute to a steal phenomenon.
血管窃血现象被认为有助于解释微血管重建术后的终末器官缺血。有人试图通过简单电路模拟血液循环来阐明血管窃血的机制,这表明游离皮瓣为血流提供了一条阻力最小的路径,从而损害了终末器官的灌注。我们报告了一例使用大腿后内侧穿支皮瓣修复糖尿病足溃疡的病例,该患者足部仅有一支血管供血。在此病例背景下,我们运用哈根 - 泊肃叶定律及流体动力学中的水头损失特性对窃血现象提出了一种新的解释,并讨论了游离皮瓣的血管大小如何导致窃血现象。