Cho B C, Lee M S, Lee J H, Byun J S, Baik B S
Department of Plastic and Reconstructive Surgery at Kyungpook National University Hospital, Taegu, Korea.
Plast Reconstr Surg. 1998 Sep;102(4):1134-43. doi: 10.1097/00006534-199809040-00033.
The aim of this study was to investigate the efficacy of a surgical delay procedure and a combined surgical and chemical delay procedure on the survival of arterialized venous flaps. Experimental groups included (1) a control group, (2) a surgical delay (4-day and 7-day delay) group, and (3) a combined surgical and chemical (doxazosin mesylate, nitroglycerine patch) delay group. These groups were further divided into subgroups (n = 10) depending on the delay period and the chemical agents. An arterialized venous flap was created on one ear of each rabbit. In the arterialized venous flap, arterial inflow was provided by anastomosis of the central auricular artery to the anterior branch of the central auricular vein and a venous outflow through the anterior marginal vein. In the control group, the arterialized venous flaps without any delay procedure showed complete necrosis of all flaps. In the surgical delay group, the mean percentage survival of arterialized venous flaps was 36.6 percent in the 4-day delay group and 59.7 percent in the 7-day delay group. In the combined surgical and chemical delay group, a 3-day chemical delay followed by a 4-day simultaneous surgical and chemical delay resulted in mean percentage survival of the arterialized venous flaps of 81.1 percent in the doxazosin mesylate group, 72.8 percent in the nitroglycerine patch group, and 92.9 percent in a combination group of doxazosin mesylate and nitroglycerine patch. A 3-day chemical delay followed by a 7-day simultaneous surgical and chemical delay resulted in mean percentage survival of the arterialized venous flaps of 94 percent in the doxazosin mesylate group, 90.2 percent in the nitroglycerine patch group, and 99 percent in a combination group of doxazosin mesylate and nitroglycerine patch. In conclusion, the surgical delay procedure increased the percentage survival of the arterialized venous flaps in proportion to the delay period. The combination group of surgical and chemical delay procedures had a significantly greater percentage survival than that of the surgical delay group (p < 0.001), and the delay period could be shortened.
本研究的目的是探讨手术延迟程序以及手术与化学联合延迟程序对动脉化静脉皮瓣存活的疗效。实验组包括：(1) 对照组；(2) 手术延迟（4天和7天延迟）组；(3) 手术与化学（甲磺酸多沙唑嗪、硝酸甘油贴片）联合延迟组。这些组根据延迟时间和化学制剂进一步分为亚组（n = 10）。在每只兔子的一只耳朵上制作一个动脉化静脉皮瓣。在动脉化静脉皮瓣中，通过将耳中央动脉与耳中央静脉前支吻合提供动脉血流，并通过前缘静脉进行静脉流出。在对照组中，未进行任何延迟程序的动脉化静脉皮瓣全部出现完全坏死。在手术延迟组中，4天延迟组动脉化静脉皮瓣的平均存活百分比为36.6%，7天延迟组为59.7%。在手术与化学联合延迟组中，3天化学延迟后接着4天手术与化学同步延迟，甲磺酸多沙唑嗪组动脉化静脉皮瓣的平均存活百分比为81.1%，硝酸甘油贴片组为72.8%，甲磺酸多沙唑嗪与硝酸甘油贴片联合组为92.9%。3天化学延迟后接着7天手术与化学同步延迟，甲磺酸多沙唑嗪组动脉化静脉皮瓣的平均存活百分比为94%，硝酸甘油贴片组为90.2%，甲磺酸多沙唑嗪与硝酸甘油贴片联合组为99%。总之，手术延迟程序使动脉化静脉皮瓣的存活百分比随延迟时间成比例增加。手术与化学联合延迟程序组的存活百分比显著高于手术延迟组（p < 0.001），且延迟时间可以缩短。
