Faculty Depth of Orthopaedics, Pamukkale University Medicine, Denizli 20160, Turkey.
Faculty Depth of Nucleer Medicine, Pamukkale University Medicine, Denizli 20160, Turkey.
Medicina (Kaunas). 2024 Oct 15;60(10):1689. doi: 10.3390/medicina60101689.
: Complex wounds in the hand and distal lower extremities pose challenges in reconstructive surgery, often involving critical structures like tendons. Tendon injuries, prevalent in such wounds, necessitate optimal repair methods for functional recovery. This study investigates the impact of vascularised and nonvascularised adipofascial tissue on tendon repair, focusing on early healing stages, mobilisation, and scintigraphic evaluation of flap vascularity. Wistar Albino rats were divided into groups undergoing primary tendon repair, vascularised adipofascial flap application, or nonvascularised flap application. Scintigraphic evaluation and histopathological assessment were performed to analyse healing processes. : Pedicle-free flaps support healing in tendon injuries without negatively affecting medium-term outcomes. Vascularised flaps exhibit faster healing. The scintigraphic analysis showed that the static measurements of the late phase were statistically significantly higher in the group with the non-vascularised adipofascial flap ( = 0.038). The mean perfusion reserve was higher in the vascularised pedicled adipofascial flap group than the non-vascularised adipofascial flap group. Scintigraphic analysis highlights the viability of pedicle-free flaps. : Pedicle-free adipofascial flaps support the healing of the tendon without complicating the results, while vascularised flaps show accelerated healing. These findings provide valuable insights into optimising tendon repair strategies using adipofascial flaps, with implications for enhancing functional recovery in complex wounds.
手部和远端下肢的复杂伤口给重建手术带来了挑战，这些伤口通常涉及到肌腱等关键结构。这些伤口中常见的肌腱损伤需要采用最佳的修复方法来恢复功能。本研究旨在探讨带血管和不带血管脂肪筋膜组织对肌腱修复的影响，重点关注早期愈合阶段、活动度以及皮瓣血管化的闪烁扫描评估。将 Wistar Albino 大鼠分为三组，分别进行原发性肌腱修复、带血管脂肪筋膜皮瓣应用和不带血管皮瓣应用。采用闪烁扫描评估和组织病理学评估来分析愈合过程。研究结果表明，无蒂皮瓣支持肌腱损伤的愈合，且不会对中期结果产生负面影响。带血管的皮瓣愈合更快。闪烁扫描分析显示，无血管化脂肪筋膜皮瓣组的晚期静态测量值在统计学上显著高于非血管化脂肪筋膜皮瓣组（=0.038）。带血管蒂脂肪筋膜皮瓣组的平均灌注储备高于非血管化脂肪筋膜皮瓣组。闪烁扫描分析突出了无蒂皮瓣的活力。无蒂脂肪筋膜皮瓣支持肌腱愈合而不影响结果，而带血管皮瓣则显示出更快的愈合速度。这些发现为使用脂肪筋膜瓣优化肌腱修复策略提供了有价值的见解，对增强复杂伤口中的功能恢复具有重要意义。
