Fowler J D, Degner D A, Walshaw R, Walker D
Department of Veterinary Anesthesiology, Radiology, and Surgery, Western College of Veterinary Medicine, Saskatoon, Saskatchewan, Canada.
Vet Surg. 1998 Sep-Oct;27(5):406-12. doi: 10.1111/j.1532-950x.1998.tb00147.x.
To evaluate the outcomes and complications in a consecutive series of animals undergoing microvascular reconstructive procedures at two veterinary institutions.
Retrospective study.
A total of 44 client-owned dogs and one red-necked wallaby.
The medical records of all animals undergoing reconstructive microsurgical procedures at the Western College of Veterinary Medicine and Michigan State University were reviewed. Microvascular flap survival and related complications were described. Statistical analysis was performed to determine the significance of relationships between operative factors and outcome.
A total of 57 microvascular procedures were performed on 55 animals. Reconstruction was required after trauma in 42 animals, after ablative cancer surgery in 11 animals and for correction of congenital tissue aplasia in I animal. Donor tissues included the superficial cervical cutaneous, medial saphenous fasciocutaneous or musculofasciocutaneous, caudal superficial epigastric cutaneous, trapezius muscle or musculocutaneous, caudal sartorius muscle, latissimus dorsi muscle or musculocutaneous, cranial abdominal myoperitoneal, carpal footpad, digital footpad, and vascularized ulnar bone flaps. A total of 53 of 57 flaps (93%) survived. There was a significant relationship between flap failure and level of assistant surgeon experience (P < .05). Latissimus dorsi flaps were significantly more likely to fail when compared with pooled data from all other flap types (P < .01).
The success of microvascular tissue transfer in this case series compares favorably with those reported in human reconstructive microsurgery. Both the primary and assistant surgeon should be practiced in microsurgical technique. Failure of latissimus dorsi flaps was not likely caused by an inherently deficient flap design, but was more likely attributed to the location and severity of trauma at the recipient site, the difficulty in isolating suitable recipient vessels for anastomosis or the absence of a trained assistant surgeon during these procedures. Clinical Relevance-This retrospective study documents the successful application of microvascular technique in a series of clinical cases requiring tissue reconstruction.
评估在两家兽医机构连续接受微血管重建手术的一系列动物的手术结果及并发症。
回顾性研究。
共有44只客户拥有的犬和1只赤颈袋鼠。
回顾了在西部兽医学院和密歇根州立大学接受重建显微外科手术的所有动物的病历。描述了微血管皮瓣存活情况及相关并发症。进行统计分析以确定手术因素与结果之间关系的显著性。
对55只动物共进行了57例微血管手术。42只动物因创伤后需要重建，11只动物因癌症切除术后需要重建，1只动物因先天性组织发育不全需要矫正。供体组织包括颈浅皮肤、隐神经浅筋膜皮瓣或肌筋膜皮瓣、腹壁浅尾侧皮肤、斜方肌或肌皮瓣、缝匠肌尾侧肌瓣、背阔肌或肌皮瓣、腹前肌腹膜瓣、腕垫、趾垫和带血管蒂尺骨瓣。57个皮瓣中有53个（93%）存活。皮瓣失败与助理外科医生的经验水平之间存在显著关系（P < .05）。与所有其他皮瓣类型的汇总数据相比，背阔肌皮瓣失败的可能性显著更高（P < .01）。
本病例系列中微血管组织移植的成功率与人类重建显微外科手术报告的成功率相比具有优势。主刀医生和助理外科医生都应熟练掌握显微外科技术。背阔肌皮瓣失败不太可能是由于皮瓣设计本身存在缺陷，而更可能归因于受区创伤的位置和严重程度、分离合适的受区血管进行吻合的困难程度或手术过程中缺乏训练有素的助理外科医生。临床意义——这项回顾性研究记录了微血管技术在一系列需要组织重建的临床病例中的成功应用。
