González-García José A, Chiesa-Estomba Carlos M, Álvarez Leire, Altuna Xabier, García-Iza Leire, Thomas Izaskun, Sistiaga Jon A, Larruscain Ekhiñe
Head and Neck Surgery and Reconstructive Section, Otorhinolaryngology and Head and Neck Surgery Department, Hospital Universitario Donostia, Donostia-San Sebastián, Spain.
Head and Neck Surgery and Reconstructive Section, Otorhinolaryngology and Head and Neck Surgery Department, Hospital Universitario Donostia, Donostia-San Sebastián, Spain.
J Surg Res. 2018 Jul;227:81-87. doi: 10.1016/j.jss.2018.02.025. Epub 2018 Mar 13.
Perforator free flap-based reconstruction of the head and neck is a challenging surgical procedure and needs a steep learning curve. A reproducible mammal large animal model with similarities to human anatomy is relevant for perforator flap raising and microanastomosis. The aim of this study was to assess the feasibility of a swine model for perforator-based free flaps in reconstructive microsurgery.
Eleven procedures were performed under general anesthesia in a porcine model, elevating a skin flap vascularized by perforating musculocutaneous branches of the superior epigastric artery to evaluate the relevance of this model for head and neck reconstructive microsurgery.
The anterior abdominal skin perforator-based free flap in a swine model irrigated by the superior epigastric artery was elevated in eleven procedures. In six of these procedures, we could perform an arterial and venous microanastomosis to the great vessels located in the base of the neck.
The porcine experimental model of superior epigastric artery perforator-based free flap reconstruction offers relevant similarities to the human deep inferior epigastric artery perforator flap. We could demonstrate this model as acceptable for perforator free flap training due to the necessity of perforator and pedicle dissection and transfer to a distant area.
基于穿支游离皮瓣的头颈部重建是一项具有挑战性的外科手术,需要陡峭的学习曲线。一种与人体解剖结构相似且可重复的哺乳动物大动物模型对于穿支皮瓣的掀起和显微吻合至关重要。本研究的目的是评估猪模型在重建显微外科中用于基于穿支的游离皮瓣的可行性。
在猪模型中进行了11例全身麻醉下的手术,掀起由腹壁上动脉穿支肌皮支供血的皮瓣,以评估该模型对头颈部重建显微外科的相关性。
在11例手术中掀起了猪模型中由腹壁上动脉供血的基于前腹壁皮肤穿支的游离皮瓣。在其中6例手术中,我们能够对位于颈部根部的大血管进行动静脉显微吻合。
基于腹壁上动脉穿支游离皮瓣重建的猪实验模型与人体腹壁下动脉穿支皮瓣有相关相似性。由于需要进行穿支和蒂的解剖并转移到远处区域,我们可以证明该模型对于穿支游离皮瓣训练是可接受的。