Mutaf M
Department of Plastic and Reconstructive Surgery Nagasaki University, School of Medicine, Japan.
Ann Plast Surg. 1996 Jul;37(1):75-83. doi: 10.1097/00000637-199607000-00012.
So far, the venous side of vascular changes in expanded skin has been neglected by plastic surgeons. In this experimental study, using a rabbit saphenous flap model, the author attempts to document the changes in the cutaneous venous tree that occur following expansion. Fifteen male New Zealand White rabbits were divided into three groups, with 5 animals in each: group I (expansion), with an inflated expander; group II (sham), with a noninflated expander; and group III (control), with no surgery prior to flap harvest. After an expansion period of 3 weeks with an 80-ml round tissue expander, the flaps were harvested and underwent microangiographic and histological examination in all groups. Using both legs of each animal, 10 flaps were studied for each group. The results revealed that, in the expanded skin, the cutaneous venous tree shows an increased vascularity associated with neovessel formation. In addition to the entire venous network being remarkably enlarged, the collateral and communicating veins bypassing the venous valves in the axial veins were extremely dilated. The periarterial microveins and the perivenous arterioles were also dilated and increased in number. Moreover, the venous valves were found to be incompetent following expansion. Possible mechanisms to explain these changes in the cutaneous venous system following expansion are discussed.
到目前为止，整形外科医生一直忽视扩张皮肤中血管变化的静脉侧。在这项实验研究中，作者使用兔隐静脉皮瓣模型，试图记录扩张后皮肤静脉树的变化。15只雄性新西兰白兔被分为三组，每组5只：第一组（扩张组），植入充气扩张器；第二组（假手术组），植入未充气扩张器；第三组（对照组），在切取皮瓣前未进行手术。使用80毫升圆形组织扩张器进行3周的扩张期后，所有组均切取皮瓣并进行微血管造影和组织学检查。每组使用每只动物的两条腿，共研究10个皮瓣。结果显示，在扩张的皮肤中，皮肤静脉树显示血管增多并伴有新血管形成。除了整个静脉网络显著扩大外，绕过轴向静脉中静脉瓣膜的侧支静脉和交通静脉极度扩张。动脉周围微静脉和静脉周围小动脉也扩张且数量增加。此外，发现扩张后静脉瓣膜功能不全。文中讨论了解释扩张后皮肤静脉系统这些变化的可能机制。
