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[多区域穿支皮瓣远端血流动力学的进一步研究]

[Further study of hemodynamics in the distal end of multi-territory perforator flap].

作者信息

Cao Zilong, Liu Liqiang

机构信息

No.1 Department of Scar and Wound Treatment, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100144, P. R. China.

出版信息

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2022 Dec 15;36(12):1534-1541. doi: 10.7507/1002-1892.202208113.

Abstract

OBJECTIVE

To summarize and discuss the key factors affecting the hemodynamics in the distal end of the multi-territory perforator flap, so as to provide a theoretical basis for the follow-up research and clinical application in this field.

METHODS

The related recent literature about multi-territory perforator flaps was extensively reviewed, and the concepts and researches of perforasome, choke vessel zone, arterial super-charge, and venous super-drainage were summarized.

RESULTS

The multi-territory perforator flap is composed of multiple perforasomes, and there are different types of vascular anastomosis in the choke vessel zones, which have important impacts on the hemodynamics of the flap. In order to ensure the survival of the multi-territory perforator flap, arterial super-charge and venous super-drainage are mainly used in clinical practice. However, no consensus has been reached on the choice of the two techniques. The different distribution of blood vessels in the flap, the number of perforasomes, and the type of vascular anastomosis may be the main reasons for the different results.

CONCLUSION

The location, diameter, and axial characteristics of perforators, the number of perforasomes, and the type of vascular anastomosis are the key factors affecting the hemodynamics of the multi-territory perforator flaps, which should be paid attention to in preoperative design and surgical procedure.

摘要

目的

总结并探讨影响多区域穿支皮瓣远端血流动力学的关键因素,为该领域的后续研究及临床应用提供理论依据。

方法

广泛查阅近期关于多区域穿支皮瓣的相关文献,总结穿支体、阻断血管区、动脉增压及静脉超引流的概念及研究。

结果

多区域穿支皮瓣由多个穿支体组成,阻断血管区内存在不同类型的血管吻合,对皮瓣血流动力学有重要影响。为确保多区域穿支皮瓣存活,临床主要采用动脉增压和静脉超引流,但两种技术的选择尚未达成共识。皮瓣内血管分布不同、穿支体数量及血管吻合类型可能是导致结果不同的主要原因。

结论

穿支的位置、直径及轴向特征、穿支体数量和血管吻合类型是影响多区域穿支皮瓣血流动力学的关键因素,在术前设计和手术操作中应予以重视。

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[Further study of hemodynamics in the distal end of multi-territory perforator flap].
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J Craniofac Surg. 2022 Jun 1;33(4):1066-1070. doi: 10.1097/SCS.0000000000008412. Epub 2021 Dec 8.
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Trop Doct. 2021 Jul;51(3):339-344. doi: 10.1177/00494755211020854. Epub 2021 May 31.
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Augmentation of Perforator Flap Blood Supply with Vascular Supercharge or Flap Prefabrication: Evaluation in a Rat Model.
Plast Reconstr Surg. 2021 May 1;147(5):1105-1115. doi: 10.1097/PRS.0000000000007893.
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Improvement of multiterritory perforator flap survival supported by a hybrid perfusion mode: A novel strategy and literature review.
J Tissue Viability. 2021 May;30(2):276-281. doi: 10.1016/j.jtv.2020.12.007. Epub 2021 Jan 4.
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Correlation between blood flow, tissue volume and microvessel density in the flap.
Nagoya J Med Sci. 2020 May;82(2):291-300. doi: 10.18999/nagjms.82.2.291.
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[Effect of natural hirudin on revascularization of ischemic skin flaps in rats by Micro-CT].
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