Degner D A, Walshaw R, Arnoczky S P, Smith R J, Patterson J S, Degner L A, Hamaide A, Rosenstein D
Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing 48824-1314, USA.
Vet Surg. 1996 Jul-Aug;25(4):292-9. doi: 10.1111/j.1532-950x.1996.tb01416.x.
This study evaluates the cranial rectus abdominus muscle pedicle flap as the sole blood supply for the caudal superficial epigastric skin flap. This flap was composed of a cranially based rectus abdominus muscle pedicle flap that was attached to the caudal superficial epigastric island skin flap (including mammary glands 2 to 5) via the pudendoepigastric trunk. Selective angiography of the cranial epigastric artery in eight cadaver dogs proved that the arterial vasculature in the cranial rectus abdominus was contiguous with that in the caudal superficial epigastric skin flap. In the live dog study, three of six of the flaps failed because of venous insufficiency. Necrosis of mammary gland 2 occurred in two of six flaps. One of six flaps survived with the exception of the cranial most aspect of mammary gland 2. Angiography of the cranial epigastric artery proved that arterial blood supply to these flaps was intact. Histological evaluation of the failed flaps showed full-thickness necrosis of the skin and subcutaneous tissues, the presence of severe congestion, and venous thrombosis. Retrograde venous blood flow through the flap was inconsistent, and hence resulted in failure of this myocutaneous flap. Use of this flap for clinical wound reconstruction cannot be recommended.
本研究评估将颅侧腹直肌蒂皮瓣作为腹壁浅动脉尾侧皮瓣的唯一血供。该皮瓣由一个以颅侧为蒂的腹直肌蒂皮瓣组成，该皮瓣通过阴部腹壁干与腹壁浅动脉尾侧岛状皮瓣（包括2至5号乳腺）相连。对8只犬尸体的腹壁上动脉进行选择性血管造影，结果表明颅侧腹直肌的动脉血管系统与腹壁浅动脉尾侧皮瓣的动脉血管系统相连。在活体犬研究中，6个皮瓣中有3个因静脉功能不全而失败。6个皮瓣中有2个出现2号乳腺坏死。6个皮瓣中有1个存活，但2号乳腺最颅侧部分除外。腹壁上动脉血管造影显示这些皮瓣的动脉血供完整。对失败皮瓣的组织学评估显示皮肤和皮下组织全层坏死，存在严重充血和静脉血栓形成。皮瓣的逆行静脉血流不一致，因此导致该肌皮瓣失败。不建议将该皮瓣用于临床伤口重建。
