Smith R J, Fukuta K, Wheatley M, Jackson I T
Institute for Craniofacial and Reconstructive Surgery, Southfield, Michigan.
Br J Plast Surg. 1994 Jan;47(1):10-4. doi: 10.1016/0007-1226(94)90110-4.
This study was performed to investigate the role of perivenous areolar tissue and flap bed in the viability of venous flaps in the rabbit ear model as described by Inada et al. Six groups of flaps were studied: group A--flap based on a proximal vein and areolar tissue; group B--flap based on a proximal venous pedicle which has been skeletonised; group C--flaps based on a proximal vein and areolar tissue sutured over a full thickness skin graft (FTSG), preventing diffusion into the flap; group D--flaps with a skeletonised pedicle sutured over a FTSG; group E--control, non-vascularised flap placed directly on bed; and Group F--control, non-vascularised flap sutured over a FTSG. Groups C and D had 15 flaps and the remaining groups had 10 flaps in each. All flaps in groups A and B had total or partial survival. In group C 4 flaps survived completely, 8 had partial survival and 3 necrosed. Group D had only 2 flaps with partial survival with 13 flaps with total loss. In group E there were 10 flaps with partial survival and none with complete loss. No flaps in group F survived. Histological examination of the pedicle showed small vascular channels present in the areolar tissue surrounding the venous pedicle. This study confirms the importance of the perivenous areolar tissue in the perfusion of the venous skin flap in the rabbit ear model.
本研究旨在按照稻田等人所描述的方法，在兔耳模型中探讨静脉周围疏松结缔组织和皮瓣床对静脉皮瓣存活能力的作用。研究了六组皮瓣：A组——基于近端静脉和疏松结缔组织的皮瓣；B组——基于已去除周围组织的近端静脉蒂的皮瓣；C组——基于近端静脉和疏松结缔组织并缝合于全厚皮片（FTSG）上的皮瓣，防止物质扩散至皮瓣；D组——带去除周围组织的蒂并缝合于FTSG上的皮瓣；E组——对照组，直接置于皮瓣床上的非血管化皮瓣；F组——对照组，缝合于FTSG上的非血管化皮瓣。C组和D组每组有15个皮瓣，其余组每组有10个皮瓣。A组和B组的所有皮瓣均完全或部分存活。C组有4个皮瓣完全存活，8个部分存活，3个坏死。D组只有2个皮瓣部分存活，13个皮瓣完全坏死。E组有10个皮瓣部分存活，无完全坏死的皮瓣。F组无皮瓣存活。对蒂部的组织学检查显示，静脉蒂周围的疏松结缔组织中存在小血管通道。本研究证实了静脉周围疏松结缔组织在兔耳模型静脉皮瓣灌注中的重要性。
