Plastic Surgery Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing City, China.
Chengdu Badachu Medical Aesthetics Hospital, Chengdu City, Sichuan Province,China.
J Craniofac Surg. 2023 May 1;34(3):e255-e259. doi: 10.1097/SCS.0000000000009172. Epub 2023 Jan 19.
Arteriovenous loops have a high potency to induce angiogenesis and are promising to solve the problem of scarce implanted pedicle sources and insufficient neovascularization in flap prefabrication. But there is a lack of large animal experiments to support their clinical application. Therefore, we aimed to explore the feasibility of prefabricating large flaps based on arteriovenous loops in pigs.
Five minipigs were used. In the experimental group, a 10-cm-long ear vein graft was microanastomosed with the saphenous artery and vein to form an arteriovenous loop and implanted under the medial thigh flap. A month later, a 10×10 cm prefabricated flap pedicled with the arteriovenous loop was elevated and sutured in situ. In the control group, a 10×10 cm flap with no vascular pedicle was elevated completely and sutured in situ in the same position. The patency of the arteriovenous loop was evaluated by angiography 30 days after implantation, and the viability of flaps was assessed by macroscopic analysis 10 days after elevation. Three animals received arteriovenous loop flaps unilaterally and no-pedicle flaps unilaterally. Two animals received arteriovenous loop flaps bilaterally.
In the experimental group, no thrombi were exhibited in any arteriovenous loop. All 7 prefabricated flaps survived uneventfully. In the control group, 3 flaps were completely necrotic.
The arteriovenous loops with long interpositional venous grafts can be used as vascular pedicles to prefabricated large area and well-vascularized flaps. This approach can greatly expand the application of flap prefabrication.
动静脉环具有很强的血管生成能力，有望解决皮瓣预制中植入蒂源不足和新生血管不足的问题。但缺乏大动物实验来支持其临床应用。因此，我们旨在探索在猪身上预制基于动静脉环的大皮瓣的可行性。
使用 5 头小型猪。实验组将 10cm 长的耳静脉移植物与隐动脉和隐静脉显微吻合形成动静脉环，并植入股内侧皮瓣下。一个月后，用动静脉环为蒂预制 10×10cm 皮瓣并原位抬高缝合。对照组在同一位置完全抬高无血管蒂的 10×10cm 皮瓣并原位缝合。植入后 30 天通过血管造影评估动静脉环的通畅性，抬高后 10 天通过大体分析评估皮瓣的存活情况。3 只动物单侧接受动静脉环皮瓣，单侧接受无蒂皮瓣。2 只动物双侧接受动静脉环皮瓣。
实验组所有动静脉环均无血栓形成。7 个预制皮瓣均顺利存活。对照组 3 个皮瓣完全坏死。
带有长静脉移植物的动静脉环可用作血管蒂预制大面积、血供良好的皮瓣。这种方法可以极大地扩展皮瓣预制的应用。
