Maitz P K, Pribaz J J, Hergrueter C A
Division of Plastic Surgery, Brigham/Children's/Harvard, Boston Massachusetts, USA.
Microsurgery. 1996;17(1):35-40. doi: 10.1002/(SICI)1098-2752(1996)17:1<35::AID-MICR7>3.0.CO;2-V.
This study was designed to determine whether tissue expansion after vascular pedicle implantation would increase the survival area of prefabricated skin flaps. In 20 New Zealand white rabbits, the vascular pedicle consisting of the central artery and vein of the left ear was implanted into the neck. At the time of pedicle implantation a subcutaneous pocket was created measuring 5 x 14 cm beneath the implantation site. Tissue expanders of three different sizes and volumes were implanted in the rabbits of three treatment groups. No tissue expander was implanted in the animals of the control group. All flaps were transposed after 3 weeks to the contralateral ear, and flap survival was assessed 1 week later. The increased area of the flap survival was statistically significant in all three treatment groups compared to the nonexpanded flaps (P = 0.003, P = 0.004, P < 0.0001, respectively). In addition there was a statistically significant larger area of survival using a 100-cc expander measuring 5 x 14 cm (the same size as the elevated flap) compared to 40-cc (3 x 5 cm) or to 60-cc (4 x 8 cm) expanders (P < 0.001, P = 0.004, respectively). The one-way analysis of variance and the t-test were used to show statistical differences. We conclude that the time necessary for neovascularisation of the skin flap could be used to expand the tissue, not only increasing the amount of available tissue, but also enhancing the vascularity.
本研究旨在确定血管蒂植入后组织扩张是否会增加预制皮瓣的存活面积。在20只新西兰白兔中，将由左耳中央动静脉组成的血管蒂植入颈部。在植入血管蒂时，于植入部位下方创建一个5×14厘米的皮下腔隙。三个治疗组的兔子分别植入三种不同尺寸和体积的组织扩张器。对照组动物不植入组织扩张器。3周后将所有皮瓣转移至对侧耳朵，1周后评估皮瓣存活情况。与未扩张的皮瓣相比，所有三个治疗组皮瓣存活面积的增加均具有统计学意义（分别为P = 0.003、P = 0.004、P < 0.0001）。此外，与40立方厘米（3×5厘米）或60立方厘米（4×8厘米）的扩张器相比，使用尺寸为5×14厘米（与抬高的皮瓣相同大小）的100立方厘米扩张器时，皮瓣存活面积在统计学上显著更大（分别为P < 0.001、P = 0.004）。采用单因素方差分析和t检验来显示统计学差异。我们得出结论，皮瓣新生血管形成所需的时间可用于组织扩张，这不仅增加了可用组织的量，还增强了血管形成。
