Mandlik V, Kehrer A, Jiga L, Hoinoiu B, Ionac M, Jung F, Staudenmaier R, Prantl L
Department of Plastic, Hand and Reconstructive Surgery, University Medical Center Regensburg, Germany.
Division of Microsurgery, Pius Branzeu Center for Laparoscopic Surgery and Microsurgery, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania.
Clin Hemorheol Microcirc. 2016;64(3):319-331. doi: 10.3233/CH-168120.
The technique of flap-prefabrication has been successfully established in tissue engineering: missing intrinsic vascularisation of engineered tissue can be generated in vivo by microsurgical vesselloop construction. It is possible to move engineered tissue into a defect with microsurgery. In the literature, the combination of engineered tissue covered with skin is not widely reported.
Aim of this study was to establish a model to investigate scaffold prefabrication with full thickness skin graft coverage with subsequent free tissue transfer.
8 Wistar rats were operated in 2 separate steps: 1) after creating an arteriovenous loop with the femoral vessels, a porous scaffold was placed on the loop and covered with an inguinally based skin flap. A control was implanted without loop into the contralateral groin. 2) 6 weeks later the prefabricated composite flaps were microsurgically transferred to the cervical region. Skin-island monitoring was performed with Laser Doppler-scanner after the transfer.
Continuous loss of the skin islands was observed within 72 hours. Complications included wound-dehiscence, thrombosis and death from anaesthesia; in spite of consistent loop viability.
Evaluation showed that modifications are necessary to maintain the skin-island cove.
皮瓣预制技术已在组织工程中成功建立：通过显微外科血管襻构建可在体内生成工程组织缺失的固有血管化。利用显微外科手术可将工程组织转移至缺损处。在文献中，覆盖皮肤的工程组织组合报道并不广泛。
本研究旨在建立一个模型，用于研究带全厚皮片覆盖的支架预制及随后的游离组织移植。
8只Wistar大鼠分两个独立步骤进行手术：1）用股血管构建动静脉襻后，将多孔支架置于襻上，并用腹股沟皮瓣覆盖。对侧腹股沟植入无襻的对照物。2）6周后，将预制的复合皮瓣显微外科转移至颈部区域。转移后用激光多普勒扫描仪进行皮岛监测。
72小时内观察到皮岛持续丢失。并发症包括伤口裂开、血栓形成和麻醉死亡；尽管血管襻存活情况良好。
评估表明，为维持皮岛覆盖需要进行改进。
