Department of Clinical medicine, The Second School of Medicine, Wenzhou Medical University, China.
Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, The Second School of Medicine, Wenzhou Medical University, China.
J Plast Reconstr Aesthet Surg. 2021 Oct;74(10):2768-2775. doi: 10.1016/j.bjps.2021.03.046. Epub 2021 Mar 29.
The investigation and practice of physical therapy in flap surgery are still scare. The purpose of this study is to evaluate the impact of different microneedling interventions on survival of random pattern flaps in rats, attempting to determine the optimal microneedling protocols for improvement of flap survival.
Eighty male Sprague-Dawley rats were randomly divided into four groups, with 20 in each group (group A, B, C, and D). A 3 cm × 9 cm rectangular random flap as the McFarlane flap was adopted in each group. In groups A and B, microneedling treatment was performed before and after surgery, respectively. While animals in group C were received both pre- and postoperative microneedling treatment. Group D was used as a control group, which was only exposed to surgery. Flap survival, flap blood flow, number of capillary formations, the expressions of CD31, CD34, HIF-1α, and vascular endothelial growth factor (VEGF) were detected in each group and compared.
On the 7th day postoperatively, significant improvements with microneedling treatment were found in flap survival rate (p = 0.007), blood flow (p = 0.024), the expression levels of CD34 (p = 0.005), and the VEGF (p < 0.01). Furthermore, the VEGF expression level was significantly higher in group B when compared with the other three groups (all p < 0.01). However, there was no significant difference in the number of new blood vessels and other immunohistochemical indicators among the four groups (all p > 0.05).
Microneedling treatment especially postoperative intervention can significantly improve the survival of random flaps in rats.
皮瓣手术中的物理治疗的调查和实践仍然很少。本研究旨在评估不同微针干预对大鼠随意皮瓣存活的影响,试图确定改善皮瓣存活的最佳微针方案。
将 80 只雄性 Sprague-Dawley 大鼠随机分为四组,每组 20 只(A、B、C 和 D 组)。每组均采用 McFarlane 皮瓣作为 3cm×9cm 长方形随意皮瓣。A 组和 B 组分别在术前和术后进行微针治疗,C 组则同时进行术前和术后微针治疗。D 组作为对照组,仅接受手术。检测每组皮瓣存活率、皮瓣血流量、毛细血管形成数量、CD31、CD34、HIF-1α 和血管内皮生长因子(VEGF)的表达,并进行比较。
术后第 7 天,皮瓣存活率(p=0.007)、血流量(p=0.024)、CD34 表达水平(p=0.005)和 VEGF 表达水平(p<0.01)均有显著改善。此外,与其他三组相比,B 组的 VEGF 表达水平明显更高(均 p<0.01)。然而,四组之间新血管数量和其他免疫组织化学指标均无显著差异(均 p>0.05)。
微针治疗,特别是术后干预,可以显著提高大鼠随意皮瓣的存活率。