Ji Jiahao, Chen Dondli, Ni Jiamin, Chang Fei
From the Department of Plastic and Burns Surgery, The Affiliated Zhangjiagang Hospital of Soochow University, Suzhou, China.
Ann Plast Surg. 2024 Aug 1;93(2):268-275. doi: 10.1097/SAP.0000000000003980. Epub 2024 May 22.
As a significant bridge between perforasomes, choke vessels are the key structure of blood supply expansion, also a prerequisite for preventing distal ischemic necrosis of the multiterritory perforator flap, where the remodeling of choke vessels after flap elevation plays an essential role. This systematic review highlights the underlying mechanisms and clinical ways to promote remodeling of choke vessels, as well as experimental observation approaches to further guide researchers.
A systematic review was conducted from 1975 to 2023 through PubMed, EMBASE, Web of Science, and Cochrane database with the key words "choke vessels" and "perforator flap" to investigate the mechanisms and ways to promote remodeling of choke vessels as well as observation approaches. The inclusion criteria and exclusion criteria were set to screen the literature.
A total of 94 literatures were obtained through database retrieval. After removing the duplicate literature, reading the title and abstract, and reviewing the full text finally, 33 articles were included in the final study.
The underlying remodeling of choke vessels may be related to fluid shear stress, hypoxia, and inflammation. The clinical ways to promote remodeling of choke vessels include surgical delay, arterial supercharge, venous superdrainage, drugs, and stem cells. Various experimental methods of observing microvascular morphology allow for a comprehensive research of choke vessels.
作为穿支体之间的重要桥梁，窒息血管是血供扩张的关键结构，也是预防多区域穿支皮瓣远端缺血坏死的前提条件，皮瓣掀起后窒息血管的重塑在其中起着至关重要的作用。本系统评价着重阐述促进窒息血管重塑的潜在机制、临床方法以及进一步指导研究人员的实验观察方法。
通过PubMed、EMBASE、Web of Science和Cochrane数据库，以“窒息血管”和“穿支皮瓣”为关键词，对1975年至2023年的文献进行系统评价，以研究促进窒息血管重塑的机制、方法以及观察方法。设定纳入标准和排除标准以筛选文献。
通过数据库检索共获得94篇文献。在去除重复文献、阅读标题和摘要并最终审阅全文后，最终纳入33篇文章进行研究。
窒息血管的潜在重塑可能与流体剪切应力、缺氧和炎症有关。促进窒息血管重塑的临床方法包括手术延迟、动脉增压、静脉超引流、药物和干细胞。观察微血管形态的各种实验方法有助于对窒息血管进行全面研究。
