Haughey B H, Panje W R
Department of Otolaryngology--Head and Neck Surgery, Washington University School of Medicine, St. Louis, MO 63108.
Laryngoscope. 1989 Feb;99(2):204-12. doi: 10.1288/00005537-198902000-00014.
The purpose of this study was to develop and describe in detail a reproducible porcine model for musculocutaneous flap study. The model was required to demonstrate the following: 1. consistent, easily identifiable anatomical landmarks for muscles and muscular vascular pedicles; 2. flap survival, consistent with the musculocutaneous perforator arrangement of blood supply; 3. ease of islanded- or free-flap formation; 4. arrangement of flaps on each animal, allowing paired studies of control and experimental flaps; and 5. a maximum number of flaps per animal, without undue morbidity or mortality. Pilot dissections were made of the pectoralis, trapezius, latissimus dorsi, gracilis, biceps femoris, and tensor fasciae latae muscles and their major vascular pedicles. After establishing the anatomical landmarks, we formed musculocutaneous flaps at each site to verify the above five requirements. A total of 72 muscle/vessel pedicle dissections were performed, incorporating formation of 61 island musculocutaneous flaps. The skin component overlying an islanded muscle block survived in 60 instances, confirming the reliability of the flap model. We concluded that five pairs of musculocutaneous flaps could be fashioned on one pig, using the bilateral control/experimental paradigm if desired. The pectoralis, latissimus dorsi, trapezius, gracilis, and biceps femoris muscles were used. The ventral muscle group (pectoralis, gracilis) was raised in one operating session, and the lateral muscles (trapezius, latissimus dorsi, biceps femoris) were raised in one further session per side. Three new porcine flaps are described--the pectoralis, biceps femoris, and trapezius. Morbidity was confined to mild splinting of the limbs for one day. This is also the first example of the use of ten musculocutaneous island flaps on one pig, and represents an opportunity for performing physiological, pathological, or pharmacological experiments on the musculocutaneous flap.
本研究的目的是开发并详细描述一种用于肌皮瓣研究的可重复猪模型。该模型需具备以下特点：1. 肌肉和肌肉血管蒂有一致且易于识别的解剖标志；2. 皮瓣存活情况与肌皮穿支血供分布一致；3. 易于形成岛状瓣或游离瓣；4. 每只动物上皮瓣的布局，以便对对照瓣和实验瓣进行配对研究；5. 每只动物上的皮瓣数量最多，且无过度的发病率或死亡率。对胸肌、斜方肌、背阔肌、股薄肌、股二头肌和阔筋膜张肌及其主要血管蒂进行了初步解剖。确定解剖标志后，我们在每个部位形成肌皮瓣以验证上述五个要求。共进行了72次肌肉/血管蒂解剖，其中包括形成61个岛状肌皮瓣。60例中覆盖岛状肌块的皮肤成分存活，证实了皮瓣模型的可靠性。我们得出结论，若需要，可在一头猪身上制作五对肌皮瓣，采用双侧对照/实验模式。使用的肌肉为胸肌、背阔肌、斜方肌、股薄肌和股二头肌。腹侧肌群（胸肌、股薄肌）在一次手术中掀起，外侧肌肉（斜方肌、背阔肌、股二头肌）每侧在另一次手术中掀起。描述了三种新的猪皮瓣——胸肌瓣、股二头肌瓣和斜方肌瓣。发病率仅限于肢体轻度夹板固定一天。这也是在一头猪身上使用十个肌皮岛状瓣的首个实例，为在肌皮瓣上进行生理、病理或药理实验提供了机会。
