Department of Oral and Maxillofacial Surgery, School of Medicine, Technical University of Munich, Klinikum Rechts Der Isar, Munich, Germany.
Medical Faculty, Johannes Kepler University Linz, Linz, Austria.
Sci Rep. 2023 Jan 19;13(1):1029. doi: 10.1038/s41598-023-28054-9.
Venous-only perfusion flaps have not been used widely because of the associated high failure rate. Tissue conditioning offers a broad scope of techniques that can be applied pre-, peri-, or postoperatively to promote the adaptation of the affected tissue to any subsequent stress. This study aimed to assess the survival rates associated with a pure venous perfusion flap and investigate whether the timing of the vascular conditioning can affect free flap survival. Forty-four rats were included in the experiment. Group I underwent veno-arterial anastomoses with epigastric graft with pure venous perfusion without tissue conditioning. Groups II and III were pretreated for 7 or 14 days with ischemic conditioning. These groups were compared with a control group (group IV) of conventionally perfused flaps. After the initial surgery, all flaps were assessed clinically, photometrically, and by indocyanine green videoangiography. The flap success rates were 0% in group I, 49.97% ± 24.34% in group II, and 64.95% ± 20.36% in group III. The control group showed an overall survival of 89.3% ± 6.51%. With suitable conditioning, pure venous blood supply can provide adequate perfusion in the rat epigastric flap model. The timing of vascular conditioning appears to be critical for flap survival.
静脉灌注皮瓣由于其高失败率尚未广泛应用。组织预处理提供了广泛的技术范围，可以在术前、术中和术后应用，以促进受影响组织适应任何后续的压力。本研究旨在评估纯静脉灌注皮瓣的存活率，并探讨血管预处理的时机是否会影响游离皮瓣的存活。44 只大鼠被纳入实验。I 组行腹壁带蒂皮瓣静脉-动脉吻合术，采用纯静脉灌注，无组织预处理。II 组和 III 组分别进行 7 或 14 天的缺血预处理。这些组与常规灌注皮瓣的对照组（IV 组）进行比较。初次手术后，所有皮瓣均进行临床、光密度和吲哚菁绿视频血管造影评估。I 组皮瓣成功率为 0%，II 组为 49.97%±24.34%，III 组为 64.95%±20.36%。对照组的总存活率为 89.3%±6.51%。通过适当的预处理，纯静脉血液供应可以为大鼠腹壁皮瓣模型提供足够的灌注。血管预处理的时机对皮瓣存活似乎至关重要。
