Yan Yuyong, Pan Xinyuan, Lin Bojie, Lin Guanyu, Yin Guoqian
Department of Plastic and Aesthetic Surgery, the First Affiliated Hospital of Guangxi Medical University, Nanning Guangxi, 530021, P.R.China.
Department of Cosmetology and Plastic Surgery Center, the People's Hospital of Guangxi Zhuang Autonomous Region, Nanning Guangxi, 530021, P.R.China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2020 Mar 15;34(3):382-386. doi: 10.7507/1002-1892.201907030.
To investigate the effect of natural hirudin on revascularization of ischemic skin flap in rats using Micro-CT and three-dimensional (3D) reconstruction.
Thirty-two Sprague Dawley rats were prepared a ischemic skin flap (8.0 cm×1.8 cm) model on the back and randomly divided into hirudin group and control group (16 rats in each group). At immediate and within 3 days after operation, the rats were treated with hypodermic injection of natural hirudin 0.3 mL (including natural hirudin 6 ATU) every day in hirudin group and the equal amount of normal saline in control group. At 6 days after operation, the survival rate of skin flap was evaluated, histological changes were observed by HE staining, and the volemia, length of blood vessels, and number of blood vessels were analyzed with Micro-CT 3D reconstruction.
Both groups of rats survived to the end of the experiment without infection. Different degrees of necrosis occurred in the distal part of the skin flaps in both groups at 6 days after operation, but the flap survival rate of the hirudin group (72.11%±8.97%) was significantly higher than that of control group (58.94%±4.02%) ( =3.280, =0.008). Histological observation showed that the histological hierarchy of the hirudin group was clearer than that of the control group, with more microangiogenesis and less inflammatory response and inflammatory cell infiltration. Micro-CT 3D reconstruction showed that the flap vessels in the hirudin group were more and denser, and the volemia, length of blood vessels, and number of blood vessels were significantly higher than those in the control group ( <0.05).
Natural hirudin can reduce the inflammation of tissue, promote the regeneration and recanalization of blood vessels in ischemic skin flap, so as to improve the survival rate of the flap.
采用微型计算机断层扫描（Micro-CT）及三维（3D）重建技术，研究天然水蛭素对大鼠缺血皮瓣血管再生的影响。
32只Sprague Dawley大鼠于背部制备缺血皮瓣（8.0 cm×1.8 cm）模型，随机分为水蛭素组和对照组（每组16只）。水蛭素组大鼠于术后即刻及术后3天内，每天皮下注射0.3 mL天然水蛭素（含天然水蛭素6抗凝血酶单位），对照组注射等量生理盐水。术后6天，评估皮瓣成活率，采用苏木精-伊红（HE）染色观察组织学变化，并用Micro-CT三维重建分析血容量、血管长度及血管数量。
两组大鼠均存活至实验结束，无感染发生。术后6天，两组皮瓣远端均出现不同程度坏死，但水蛭素组皮瓣成活率（72.11%±8.97%）显著高于对照组（58.94%±4.02%）（t = 3.280，P = 0.008）。组织学观察显示，水蛭素组组织学层次较对照组清晰，微血管生成较多，炎症反应及炎性细胞浸润较少。Micro-CT三维重建显示，水蛭素组皮瓣血管较多且密集，血容量、血管长度及血管数量均显著高于对照组（P < 0.05）。
天然水蛭素可减轻组织炎症，促进缺血皮瓣血管再生及再通，从而提高皮瓣成活率。
