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微血管片段移植改善大鼠背部皮瓣存活情况。

Microvascular Fragment Transplantation Improves Rat Dorsal Skin Flap Survival.

作者信息

Stone Randolph, Rathbone Christopher R

机构信息

Extremity Trauma and Regenerative Medicine, US Army Institute of Surgical Research, Fort Sam Houston, Tex.

出版信息

Plast Reconstr Surg Glob Open. 2016 Dec 23;4(12):e1140. doi: 10.1097/GOX.0000000000001140. eCollection 2016 Dec.

Abstract

BACKGROUND

The development of flap necrosis distally remains a concern during microsurgical flap transfers because, at least in part, of decreased perfusion. Microvascular fragments (MVFs) are microvessels isolated from adipose tissue that are capable of improving tissue perfusion in a variety of tissue defects. The aim of this study was to determine whether the transplantation of MVFs in a dorsal rat skin flap model can improve flap survival.

METHODS

A 10 × 3 cm flap was raised in a cranial to caudal fashion on the dorsal side of 16 Lewis rats, with the caudal side remaining intact. The rats were equally divided into a treatment group (MVFs) and a control group (sterile saline). At the time of surgery, sterile saline with or without MVFs was injected directly into the flap. Microvessel density was determined after harvesting flap tissue by counting vessels that positively stained for Griffonia simplicifolia lectin I-isolectin B. Laser Doppler was used to measure blood flow before and after surgery and 7 and 14 days later. Flap survival was evaluated 7 and 14 days after surgery by evaluating the percentage of viable tissue of the flap with photodigital planimetry.

RESULTS

Despite the lack of a significant difference in microvessel density and tissue perfusion, flap survival increased 6.4% ( < 0.05) in MVF-treated animals compared with controls.

CONCLUSIONS

The use of MVFs may be a means to improve flap survival. Future studies are required to delineate mechanisms whereby this occurs and to further optimize their application.

摘要

背景

在显微外科皮瓣移植过程中,皮瓣远端坏死的发生仍是一个令人担忧的问题,至少部分原因是灌注减少。微血管片段(MVF)是从脂肪组织中分离出来的微血管,能够改善多种组织缺损中的组织灌注。本研究的目的是确定在大鼠背部皮瓣模型中移植MVF是否能提高皮瓣存活率。

方法

在16只Lewis大鼠的背部以头至尾的方式掀起一个10×3cm的皮瓣,尾侧保持完整。将大鼠平均分为治疗组(MVF)和对照组(无菌生理盐水)。手术时,将含有或不含有MVF的无菌生理盐水直接注入皮瓣。通过计数对四叶豆凝集素I-异凝集素B呈阳性染色的血管,在收获皮瓣组织后测定微血管密度。在手术前、手术后7天和14天使用激光多普勒测量血流。通过光数字平面测量法评估皮瓣存活组织的百分比,在手术后7天和14天评估皮瓣存活率。

结果

尽管微血管密度和组织灌注没有显著差异,但与对照组相比,接受MVF治疗的动物皮瓣存活率提高了6.4%(P<0.05)。

结论

使用MVF可能是提高皮瓣存活率的一种方法。需要进一步的研究来阐明其发生机制,并进一步优化其应用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3e8b/5222647/71c73c729c6e/gox-4-e1140-g001.jpg

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