Xiu Z, Chen Z
Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Beijing.
Zhonghua Zheng Xing Shao Shang Wai Ke Za Zhi. 1994 May;10(3):169-72.
The mechanism of survival of venous flaps was studied by observations employed in the study of microcirculation and blood vessel perfusion in rabbits. Initially, the flap was nourished by venous blood (within 72 hours): venous blood flowed slowly from the principal vein to its tributary veins, and then through the venous anastomoses (including small venous anastomoses, venular anastomoses and terminal venule anastomoses), reaching other tributary veins. No backflow from venules into capillaries was seen. The second stage was arterial nourishing and vessel reconstructive period (72 hours to 6 weeks): new vessels began to grow into the flaps at 72 hours postoperatively. 4 days postoperation, arterial flow with low velocity appeared in the primary flap arteries and the backflow of venous blood disappeared. 7 days postoperation, the abnormal, flow in 'unphysiologic' channels was replaced by the normal flow in 'physiologic' channels completely. 6 weeks postoperation, the vessel structure of venous flaps was the same as that of normal skin. These results suggested that rich venous network in venous flaps and early invasion of new blood vessels are the mainstay of venous flaps survival.
通过对家兔微循环和血管灌注研究中所采用的观察方法，对静脉皮瓣存活机制进行了研究。起初，皮瓣由静脉血滋养（72小时内）：静脉血从主要静脉缓慢流向其属支静脉，然后通过静脉吻合支（包括小静脉吻合支、微静脉吻合支和终末微静脉吻合支），到达其他属支静脉。未见微静脉向毛细血管的逆流。第二阶段为动脉滋养和血管重建期（72小时至6周）：术后72小时新血管开始长入皮瓣。术后4天，在原发性皮瓣动脉中出现低速动脉血流，静脉血逆流消失。术后7天，“非生理性”通道中的异常血流被“生理性”通道中的正常血流完全取代。术后6周，静脉皮瓣的血管结构与正常皮肤相同。这些结果表明，静脉皮瓣中丰富的静脉网络和新血管的早期侵入是静脉皮瓣存活的主要因素。
