Tsur H, Daniller A, Strauch B
Plast Reconstr Surg. 1980 Jul;66(1):85-90. doi: 10.1097/00006534-198007000-00017.
Axial flaps were elevated in a pig and rat model. Selective ligation of the vascular pedicles on days 1 to 7 following elevation of the flap demonstrated total necrosis of all flaps when the pedicles were ligated on the first, second, and third postoperative day in the pig, and up to 6 days inthe rat. Pedicle ligation beyond this time did not produce flap necorsis, indicating the establishment of adequate neovascularization for flap survival. Selective ligation of the artery or vein did not appear to be significant in the pig. In the rat flap, however, survival tended to occur sooner. Adequate neovascularization for flap survival was demonstrated as arising from both the wound edges and the bed, although vascular channels occurring from the bed appeared to be of greater importance. The relatively rapid rate of neovascularization that occurs for adequate flap survival suggests that if some way could be found to maintain flap viability during the first week, the feeding vessels need no longer remain patent and may be ligated or used for other purposes. This interesting observation has already allowed very early successful defatting of clinically transferred flaps.
在猪和大鼠模型中掀起轴型皮瓣。皮瓣掀起后第1至7天对血管蒂进行选择性结扎，结果显示，在猪模型中，术后第1、2和3天结扎血管蒂时，所有皮瓣均发生完全坏死，而在大鼠模型中，术后长达6天结扎血管蒂时皮瓣均发生完全坏死。在此时间之后进行血管蒂结扎未导致皮瓣坏死，这表明已建立了足够的新生血管以维持皮瓣存活。在猪模型中，选择性结扎动脉或静脉似乎并无显著影响。然而，在大鼠皮瓣中，存活往往出现得更早。已证实，足以维持皮瓣存活的新生血管形成于伤口边缘和创床，不过来自创床的血管通道似乎更为重要。为确保皮瓣存活而发生的相对快速的新生血管形成表明，如果能找到某种方法在第一周内维持皮瓣活力，那么供血血管无需再保持通畅，可进行结扎或用于其他目的。这一有趣的观察结果已使得临床转移皮瓣能够非常早期成功地进行去脂。
