Barker J H, van Aalst V C, Keelen P C, Bidiwala S, Frank J M, Carroll S M, Wan C, Carroll C M, Anderson G L, Joels C, Tobin G R
Department of Surgery, University of Louisville, Ky., USA.
Plast Reconstr Surg. 1997 Sep;100(3):665-9. doi: 10.1097/00006534-199709000-00019.
Dynamic myoplasty is a relatively new use for muscle flaps and has led us to revisit the mechanisms of vascular delay as a means of optimizing blood supply to muscle flaps. Despite the well-documented effectiveness of vascular delay in skin flaps, vascular delay in muscle flaps has not been widely reported. Regardless of the many mechanisms postulated in the literature as contributors to the delay effect in skin, the one element common to all these hypotheses is the importance placed on changes in the microcirculation. Based on this factor, in the present study we developed and validated an animal model in which delay-induced microvascular changes could be measured in skeletal muscle flaps. We used the hairless mouse latissimus dorsi muscle flap because its vascular distribution is similar to that of humans and its thin structure will enable us in future studies to directly view and measure its microvasculature using videomicroscopy. In 12 animals, we found that delay significantly (p < 0.01) reduced necrosis of the distal part of the muscle from 57 +/- 9 percent in nondelayed flaps (n = 7) to 22 +/- 3 percent in delayed (n = 5) flaps. In these studies, we also determined that the hairless mouse latissimus dorsi muscle flap will serve as an excellent model for defining microvascular changes throughout delay.
动力性肌成形术是肌皮瓣一种相对较新的应用，这促使我们重新审视延迟血管化机制，将其作为优化肌皮瓣血供的一种方法。尽管延迟血管化在皮瓣中的有效性已有充分记录，但在肌皮瓣中的应用尚未得到广泛报道。尽管文献中提出了许多机制来解释其在皮肤中的延迟效应，但所有这些假设的一个共同要素是对微循环变化的重视。基于这一因素，在本研究中，我们建立并验证了一种动物模型，在该模型中可以测量延迟诱导的骨骼肌皮瓣微血管变化。我们使用无毛小鼠背阔肌皮瓣，因为其血管分布与人类相似，且其薄结构将使我们在未来的研究中能够使用视频显微镜直接观察和测量其微血管。在12只动物中，我们发现延迟显著（p < 0.01）减少了肌皮瓣远端的坏死，从非延迟组（n = 7）的57 +/- 9%降至延迟组（n = 5）的22 +/- 3%。在这些研究中，我们还确定无毛小鼠背阔肌皮瓣将作为定义整个延迟过程中微血管变化的理想模型。
