Byun J S, Constantinescu M A, Lee W P, May J W
Plastic Surgery Research Laboratory, Massachusetts General Hospital, Boston, USA.
Plast Reconstr Surg. 1995 Dec;96(7):1650-9. doi: 10.1097/00006534-199512000-00019.
The effect of delay procedures on the survival of large arterialized venous flaps was studied in a rabbit ear model. Both ears of 25 New Zealand White rabbits (n = 50) were randomized into three operative groups receiving (1) no delay, (2) limited delay, or (3) extensive delay. Two weeks later the ear flap was completely divided, and arterialization of the flap venous tree was achieved by anastomosing the central artery of the ear to the anterior branch of the flap central vein. Survival area of 10 flaps in each group was assessed at 14 days. Flap vasculature was assessed in 10 additional ears in the nondelayed and extensively delayed groups by standardized vascular injections with radiopaque silicon rubber immediately, 6 hours, 24 hours, and 2 weeks after arterialization. Delay procedures significantly increased (p = 0.001, unpaired two-tailed Student's t test) survival of arterialized venous flaps in this model. Whereas all flaps in the non-delayed group underwent total necrosis, the mean viable surface area of the flaps was 67.9 percent in the limited delay group and 94.0 percent in the extensively delayed group. Lastly, angiographic studies suggest that delay procedures prior to arterialization of the venous tree enhance perfusion of the arterial tree by increasing venoarterial communications.
在兔耳模型中研究了延迟处理对大型动脉化静脉皮瓣存活的影响。将25只新西兰白兔（n = 50）的双耳随机分为三组，分别接受（1）不延迟处理、（2）有限延迟处理或（3）广泛延迟处理。两周后将耳皮瓣完全切断，通过将耳中央动脉与皮瓣中央静脉的前支吻合实现皮瓣静脉树的动脉化。在14天时评估每组10个皮瓣的存活面积。在动脉化后即刻、6小时、24小时和2周，通过用不透射线的硅橡胶进行标准化血管注射，对未延迟处理组和广泛延迟处理组的另外10只耳朵的皮瓣血管系统进行评估。在该模型中，延迟处理显著提高了（p = 0.001，非配对双尾学生t检验）动脉化静脉皮瓣的存活率。未延迟处理组的所有皮瓣均发生完全坏死，而有限延迟处理组皮瓣的平均存活表面积为67.9%，广泛延迟处理组为94.0%。最后，血管造影研究表明，在静脉树动脉化之前进行延迟处理可通过增加静脉动脉交通来增强动脉树的灌注。
