Department of Ophthalmology.
Ophthalmic Plast Reconstr Surg. 2020 Sep/Oct;36(5):481-484. doi: 10.1097/IOP.0000000000001614.
The aim of this study was to investigate how the blood perfusion in human upper eyelid skin flaps is affected by the length of the flap and the degree of stretching and rotation of the flap.
Twenty-nine upper eyelids were dissected as part of a blepharoplastic procedure in patients. The 1-cm wide proximal end of the flap remains attached, to mimic a random pattern skin flap (hereafter called a "skin flap"). Blood perfusion was measured with laser speckle contrast imaging before and after the flap was stretched with forces of 0.5, 1, and 2 N. The flap was then rotated 90°, and the same tensions were applied.
Blood perfusion decreased gradually from the base to the tip of the flap. The flap was only well perfused in the proximal 1 cm (60% at 0.5 cm and 37% at 1.0 cm) and was minimally perfused beyond 2 cm (22% at 2.0 cm). Stretching the nonrotated flaps affected perfusion slightly (decreased to 43% at 0.5 cm). Simply rotating the flaps by 90° had no significant effect on the perfusion. The combination of rotation (90°) and stretching reduced the perfusion to 22% at 2 N, when measured 0.5 cm from the base.
Blood perfusion in upper eyelid skin flaps decreases rapidly with distance from the base of the flap. Rotating and stretching the skin flap reduces blood perfusion even further, leading to minimal perfusion in this kind of flap at distances greater than 1.5 cm from the base.
本研究旨在探讨上眼睑皮瓣的血液灌注如何受到皮瓣长度、皮瓣拉伸和旋转程度的影响。
在患者的眼睑成形术中解剖了 29 个上眼睑。皮瓣的 1cm 宽近端仍然相连，以模拟随意型皮瓣（以下称为“皮瓣”）。在皮瓣拉伸至 0.5、1 和 2N 的力之前和之后，使用激光散斑对比成像测量血液灌注。然后将皮瓣旋转 90°，并施加相同的张力。
血液灌注从皮瓣的基部到尖端逐渐减少。皮瓣仅在近端 1cm 处灌注良好（0.5cm 处为 60%，1.0cm 处为 37%），超过 2cm 处灌注很少（2.0cm 处为 22%）。未旋转的皮瓣拉伸仅轻微影响灌注（在 0.5cm 处减少至 43%）。简单地将皮瓣旋转 90°对灌注没有显著影响。旋转（90°）和拉伸的组合将灌注减少至 2N 时的 22%，在距基部 0.5cm 处测量。
上眼睑皮瓣的血液灌注随距皮瓣基部的距离迅速减少。旋转和拉伸皮瓣会进一步降低血液灌注，导致这种皮瓣在距基部 1.5cm 以上的距离处灌注极小。
