Segreto Francesco, Marangi Giovanni Francesco, Signoretti Matteo, Cazzato Vito, Giorgino Riccardo, Alessandri-Bonetti Mario, Persichetti Paolo
1 "Campus Bio-Medico di Roma" University, Rome, Italy.
Surg Innov. 2019 Aug;26(4):478-484. doi: 10.1177/1553350619828902. Epub 2019 Feb 8.
Botulinum neurotoxin-A and botulinum neurotoxin-B have been shown to play a potential role in improving flap survival in animal models. The aim of this study is to review indications as well as to study injection timing, technique, and doses of botulinum neurotoxin-A and botulinum neurotoxin-B in animal models. Seventeen articles describe a total of 266 animals that underwent botulinum toxin injections before or during flap harvesting or vascular anastomosis procedure. All the studies demonstrated a beneficial effect of botulinum toxin administration in flap surgery or vascular anastomosis. Botulinum neurotoxin-A injection was shown to be a reliable approach in reducing vascular complications rate and increasing survival of flaps in animal models. The main conclusions drawn from the study include the following: perivascular injections targeting each vascular pedicle are preferred in cases of free flaps or axial flaps; subdermal injections are favorable in cases of random pattern skin flaps; and injections should be performed 7 days before flap elevation.
在动物模型中，已证明A型肉毒杆菌神经毒素和B型肉毒杆菌神经毒素在提高皮瓣存活率方面发挥着潜在作用。本研究的目的是回顾其适应症，并研究在动物模型中注射A型肉毒杆菌神经毒素和B型肉毒杆菌神经毒素的时机、技术和剂量。十七篇文章共描述了266只动物，这些动物在皮瓣切取或血管吻合手术前或手术过程中接受了肉毒杆菌毒素注射。所有研究均表明，肉毒杆菌毒素给药对皮瓣手术或血管吻合具有有益作用。在动物模型中，注射A型肉毒杆菌神经毒素被证明是降低血管并发症发生率和提高皮瓣存活率的可靠方法。该研究得出的主要结论如下：在游离皮瓣或轴型皮瓣的情况下，首选针对每个血管蒂进行血管周围注射；在随意型皮瓣的情况下，皮下注射是有利的；并且应在皮瓣掀起前7天进行注射。
