Division of Reconstructive Microsurgery, Department of Plastic Surgery, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan.
Department of Anatomic Pathology, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan.
J Reconstr Microsurg. 2020 Jul;36(6):458-465. doi: 10.1055/s-0040-1703016. Epub 2020 Mar 23.
Various surgical effects have previously been studied in an attempt to improve the functional outcome of the functioning free muscle transplantation (FFMT). However, the effect of the recipient arterial inflow on the FFMT has remained uninvestigated. This study was to investigate whether or not high flow versus low flow will affect the functional outcome of FFMT.
Rat's left gracilis FFMT model was devised and the nutrient arterial inflow was modified. Twenty-four Lewis rats were divided evenly into relatively high (0.071 mL/min) and relatively low (0.031 mL/min) blood flow groups ( < 0.001). The unoperated right sides served as the controls. Cases resulting in poor function were additionally grouped as functional failure group for comparison. Regular swimming exercise was implemented at 1 month postoperatively for 3 months. Gracilis muscle functions were then evaluated.
Compared groups were: control ( = 13), low blood flow ( = 10), high blood flow ( = 8), and functional failure ( = 5). The control group showed superior functional results over the experimental groups ( < 0.0001). In the experimental group, successful group showed superior over the poor function group ( < 0.01). However, there was no significant difference between the high- and low-flow groups.
This is the first study to evaluate the effect of arterial inflow on the FFMT. The rate of blood flow (relatively high vs. low) has little effect on the functional outcome of transferred muscle. Survival of FFMT is the major concern while performing FFMT surgery. Arterial inflow while choosing the recipient artery is not the factor for consideration.
为了改善功能性游离肌肉移植（FFMT）的功能结果，之前已经研究了各种手术效果。然而，受体动脉流入对 FFMT 的影响尚未被研究。本研究旨在探讨高流量与低流量是否会影响 FFMT 的功能结果。
设计了大鼠左股薄肌 FFMT 模型，并修改了营养动脉流入。将 24 只 Lewis 大鼠平均分为相对高（0.071ml/min）和相对低（0.031ml/min）血流组（<0.001）。未手术的右侧作为对照。功能不佳的病例另外分组为功能衰竭组进行比较。术后 1 个月开始进行常规游泳运动，持续 3 个月。然后评估股薄肌功能。
对照组（n=13）、低血流组（n=10）、高血流组（n=8）和功能衰竭组（n=5）。对照组的功能结果优于实验组（<0.0001）。在实验组中，成功组的功能优于功能不佳组（<0.01）。然而，高流量组和低流量组之间没有显著差异。
这是第一项评估动脉流入对 FFMT 影响的研究。血流速度（相对高与低）对转移肌肉的功能结果影响不大。在进行 FFMT 手术时，FFMT 的存活是主要关注点，而选择受体动脉时的动脉流入不是考虑因素。
