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兔背阔肌肌皮瓣模型:血流动力学与解剖学研究

Latissimus dorsi musculocutaneous flap model in the rabbit: a hemodynamic and anatomical study.

作者信息

Forrest C R, Pang C Y

机构信息

Division of Plastic Surgery, Hospital for Sick Children, Toronto, Ontario, Canada.

出版信息

Ann Plast Surg. 1988 Oct;21(4):335-41.

PMID:3232921
Abstract

The rabbit island and peninsular axial pattern latissimus dorsi musculocutaneous (LDM) flaps were assessed for their appropriate use as experimental musculocutaneous flap models. Contralateral island and peninsular LDM flaps (10 X 20 cm) were constructed on rabbits, and their vascular anatomy, hemodynamics, and viability were compared. Anatomical dissections and fluorescein dye studies revealed that the skin overlying the latissimus dorsi muscle received its blood supply mainly from a direct cutaneous branch of the thoracodorsal artery before its entry to the latissimus dorsi muscle. A few small musculocutaneous arteries (perforators) were seen in the proximal portion of the latissimus dorsi muscle, but these perforators provided very little blood supply to the overlying skin. Results from hemodynamic and viability studies with rabbit peninsular and island LDM flaps also indicated that the blood supply from the musculocutaneous arteries to the overlying skin paddle was small and could not reliably support the survival of the cutaneous portion of these musculocutaneous flaps. We conclude that rabbit LDM flaps are different in vascular structure and blood supply compared with the human LDM flaps. Thus, discretion should be advised in applying the rabbit peninsular or island LDM flaps as experimental flap models for the study of the pathophysiology and pharmacology of the musculocutaneous flaps relevant to the clinical situation.

摘要

评估兔岛状和半岛状轴型背阔肌肌皮瓣(LDM瓣)作为实验性肌皮瓣模型的适用性。在兔身上构建对侧岛状和半岛状LDM瓣(10×20厘米),并比较其血管解剖结构、血流动力学和存活情况。解剖学 dissections 和荧光素染料研究表明,背阔肌上方的皮肤在胸背动脉进入背阔肌之前主要由其直接皮支供血。在背阔肌近端可见一些小的肌皮动脉(穿支),但这些穿支为上方皮肤提供的血液供应极少。兔半岛状和岛状LDM瓣的血流动力学和存活研究结果还表明,肌皮动脉向上方皮瓣的血液供应很少,无法可靠地支持这些肌皮瓣皮肤部分的存活。我们得出结论,与人类LDM瓣相比,兔LDM瓣在血管结构和血液供应方面有所不同。因此应用兔半岛状或岛状LDM瓣作为与临床情况相关的肌皮瓣病理生理学和药理学研究的实验性皮瓣模型时应谨慎。

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