Izadpanah Amin, Jansen David A, Alt Eckhard U, Izadpanah Reza
From the Applied Stem Cell Laboratory, Heart and Vascular Institute, Department of Medicine, Tulane University Health Science Center, New Orleans, La.
Division of Plastic and Reconstructive Surgery, Tulane University School of Medicine, New Orleans, La.
Plast Reconstr Surg Glob Open. 2024 Apr 10;12(4):e5711. doi: 10.1097/GOX.0000000000005711. eCollection 2024 Apr.
Type 2 muscle flaps are characterized by major and minor pedicles, such that the minor pedicle is unreliable, and the major pedicle is a requirement for the success of the flap. The role of the minor pedicle, beyond the decreased caliber and decreased vascular territory in comparison to the major pedicle, is poorly understood. We sought to model the fluid dynamics of a model flap containing a major and minor pedicle to understand differences between the pedicles and the implications on perfusion.
We first generated a computer-assisted design model of a type 2 flap with a major and minor pedicle. We then performed computational fluid dynamics to analyze velocities and flow within the pedicles and flap.
In our investigation, we found that the flow velocity within the major pedicle was higher than the minor pedicle, indicative of decreased resistance to flow. Concomitantly, we found decreased pressures within the major pedicle, reflecting decreasing resistance to flow. Interestingly, we found increased kinematic viscosity in flap areas supplied by the minor pedicle, suggesting decreased flow rates and increased resistance.
We identified that the major pedicle has increased flow velocity, decreased resistance, and decreased kinematic viscosity, suggesting its dominance in maintaining flap perfusion. Our study also identifies computational fluid dynamics as a powerful tool in studying flap perfusion dynamics.
2型肌皮瓣的特点是有主要蒂和次要蒂，其中次要蒂不可靠，主要蒂是皮瓣成功的必要条件。与主要蒂相比，次要蒂除了管径变细和血管区域减小外，其作用鲜为人知。我们试图建立一个包含主要蒂和次要蒂的皮瓣模型的流体动力学模型，以了解各蒂之间的差异及其对灌注的影响。
我们首先生成了一个带有主要蒂和次要蒂的2型皮瓣的计算机辅助设计模型。然后进行计算流体动力学分析，以分析蒂部和皮瓣内的流速及血流情况。
在我们的研究中，我们发现主要蒂内的流速高于次要蒂，这表明其血流阻力降低。与此同时，我们发现主要蒂内的压力降低，反映出血流阻力减小。有趣地是，我们发现在由次要蒂供血的皮瓣区域运动粘度增加，提示流速降低且阻力增加。
我们发现主要蒂的流速增加、阻力降低且运动粘度降低，表明其在维持皮瓣灌注方面占主导地位。我们的研究还确定计算流体动力学是研究皮瓣灌注动力学的有力工具。
