Preserving osseous viability in osteocutaneous flap prefabrication: experimental study in rabbits

This study presents a technique that preserves osseous viability in prefabricated osteocutaneous flaps with a soft-tissue vascular carrier, with a pedicled skin flap acting as the vascular carrier to neovascularize a partially devascularized bone segment before its transfer. Using a total of 50 New Zealand White rabbits, two groups were randomized as experimental and control animals. In the experimental group (n = 30), a bipedicled dorsal scapular skin flap was anchored with sutures to the scapular bone, by bringing it into contact with the exposed dorsal surface of the bone after stripping the dorsal muscular attachments. Following 4 weeks of neovascularization, the prefabricated composite flaps were harvested, based on the caudally-based dorsal skin flap, after stripping the ventral muscular attachments of the bone. In the control group (n = 20), non-vascularized scapular bone grafts were implanted under bipedicled dorsal scapular skin flaps with sutures. After 4 weeks, prefabricated composite flaps were harvested, based on the caudally-based dorsal skin flap. In both groups, on day 7 after the second stage, the viability of the bony component of the flaps was evaluated by direct observation, scintigraphy, measurement of bone metabolic activity, microangiography, dye injection study, and histology. Results indicated that the bone segments in the experimental group demonstrated a greater survival than in the control group. The authors conclude that this technique of osteocutaneous flap prefabrication preserves the viability of the bony component with a soft-tissue vascular carrier, in contrast to the conventional method of pre-transfer grafting. The technique may be useful clinically in selected cases.     

Impact of tissue expansion on flap prefabrication: An experimental study in rabbits

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 × 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 × 14 cm (the same size as the elevated flap) compared to 40-cc (3 × 5 cm) or to 60-cc (4 × 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. © 1996 Wiley-Liss, Inc.     

Use of fascial grafts as an interface in flap prefabrication: an experimental study.

An experimental study was conducted to investigate whether a fascial graft can be used as an interface between a vascular pedicle and target tissue to augment tissue survival in a prefabricated flap. Thirty-six male Sprague-Dawley rats were divided into three experimental groups according to the type of the recipient bed prepared for the vascular implantation. The left saphenous vascular pedicle was used as the vascular source. A 9 x 9-cm inferiorly based peninsular abdominal flap was elevated in each animal. In group I, the pedicle was tacked beneath the abdominal flap, in which the epigastric fascial layer was untouched. In group II, a 3 x 5-cm graft of epigastric fascia was harvested from the abdominal flaps under loupe magnification. The graft was sutured back into its original position after a 180-deg rotation. The vascular pedicle was then implanted just beneath the center of the fascial graft. In group III, the same size of epigastric fascia was removed in the same manner as group II, exposing the subcutaneous layer for pedicle implantation. Four weeks later, abdominal flaps were raised as island flaps connected only to the saphenous pedicle and were sutured in place. Flap viability was assessed visually on day 7. Overall, the ultimate flap survival in group I was the largest, with some necrotic areas at the periphery of the flaps. In group II, flap survival was typically centralized over the fascial graft, and crescent-shaped necrosis was noted superiorly. In group III, an almost linear pattern of survival overlying the vascular pedicle was observed. The mean surviving flap area of group I (12.13 +/- 1.615 cm2) was statistically greater than that of group II (8.83 +/- 0.663 cm2, p < 0.001) and group III (6.3 +/- 0.815 cm2; p < 0.001). There was a statistically significant difference between the mean flap survival in groups II and III (p < 0.001). Vascular arborization was examined by microangiography, and specimens were processed for histological staining. In group II, vascularization was distributed in a larger area along the fascial graft in comparison with limited vascularization around the pedicle in group III. In this study it was revealed that the interposition of a fascial graft as an interface between the vascular source and the target tissue seems to increase the size of the prefabricated flap.     

Arterial flap (II): an experimental study in rabbits

Skin flaps are normally characterized by arterial inflow and venous outflow. However, there are several reports about experimental and clinical applications of venous and arterialized venous flaps. On the other hand, some studies evaluated the importance of different pedicle types in prefabricated flaps. It was discovered by chance that a prefabricated free flap, having arterial-only inflow, could be used successfully in eyelid reconstruction. An experimental study on arterial flaps in rabbits showed that an arterial-only inflow was adequate for flap viability until the establishment of venous neovascularization.Presented at the 14th Congress of Turkish Plastic and Reconstructive Surgery, Ankara, Turkey, October 1992     

皮瓣延迟后对皮瓣预制时间影响的实验研究

为了探寻缩短皮瓣预制时间的新方法，作者设计了两组皮瓣预制方法进行比较。Ａ组为皮瓣延迟实验组，Ｂ组为正常皮瓣预制对照组。皮瓣预制后２周进行血管灌注检查和皮瓣移植。结果：Ａ组皮瓣成活范围大，植入血管与原皮瓣之间血管吻合支多；Ｂ组皮瓣成活面积小，血管网形成范围小，吻合支少。结论：皮瓣延迟后皮瓣预制时间可大大缩短，从而缩短了手术周期。     

异体骨预制骨皮瓣的实验研究

目的 探讨异体骨异位埋置预制骨皮瓣的可行性. 方法 从2010年11月至2011年7月,用广西巴马小型猪为实验动物,先制作深低温冷冻异体骨备用;异体骨经复温后置于旋髂浅动脉供养的皮瓣组织内,按植入部位不同分3组:皮下组(A组)、深筋膜下组(B组)、肌内组(C组),术后培养观察.指标:异体骨ECT显像(分别于术后第4周、第8周、第12周),血管造影检查、异体骨病理学检查(术后第12周). 结果 3组预制骨皮瓣术后ECT扫描显示:第8周和第12周异体骨植入部位放射性较4周时增高,差异有统计学意义(P＜0.05);血管造影显示在皮下组织、筋膜下组织、肌肉组织内的异体骨均有血管化,并与相应区域旋髂浅动脉建立血管联系;病理检查可见异体骨在筋膜下组织和肌肉组织内血管化作用和诱导新骨形成较明显. 结论 可以用异体骨异位埋置预制骨皮瓣.     

Free transplantation of venous network pattern skin flap: an experimental study in rabbits

Free skin flaps using rabbit ear to replace rabbit scalp have been accomplished using only arteriovenous and venous-venous anastomosis, without arterio-arterial anastomosis. The technique produced excellent graft survival in 30 of 33 rabbits. Without the vascular anastomosis control grafts did poorly. The mechanism of flow reversed revascularization is discussed.     

大鼠隐血管束全腹壁预制皮瓣模型的实验研究

目的:探讨一种以大鼠隐血管束为预制血管蒂的全腹壁预制皮瓣模型的设计及应用价值。方法:将18只SD大鼠按Ⅰ期手术与Ⅱ期手术之间的间隔时间2、4、6周分为三组。Ⅰ期手术制备大鼠后肢隐血管束预制血管蒂,Ⅱ期手术切开皮瓣四边,形成以预制隐血管束为蒂的岛状皮瓣。Ⅰ期、Ⅱ期术后观察皮瓣血运,记录皮瓣成活面积及成活率。检测Ⅱ期皮瓣血管蒂旁局部组织中血管内皮生长因子(VEGF)含量,取成活皮瓣制作病例切片,HE染色,计算血管密度(血管数/mm2)。运用统计学方法比较各组间差异。结果:Ⅰ期术后各组大鼠腹部皮瓣全部成活;Ⅱ期术后1周,Ⅰ组皮瓣全部坏死,Ⅱ组、Ⅲ组皮瓣平均成活率分别为(14.68±1.02)%,(16.19±1.71)%(P<0.05);Ⅱ期皮瓣局部组织VEGF平均含量:Ⅰ组243.95±4.37,Ⅱ组240.89±3.11,Ⅲ组239.19±2.61(P>0.05);大鼠平均血管密度6周组较4周组略有增多,但差别不大(P>0.05)。结论:大鼠隐血管束全腹壁预制皮瓣模型,可以作为研究提高预制皮瓣成活率的基础,Ⅰ期手术与Ⅱ期手术之间的时间间隔至少需4周。     

Microcirculation of a venous flap: an experimental study with microspheres in rabbits.

In recent years, it has been found that maintenance of venous circulation alone may support a small flap with no direct arterial inflow. The clinical application of a venous flap has potential in the field of microsurgery. The purpose of this study was to evaluate the haemodynamics within a pedicled venous flap in rabbits, compared with those of a composite graft. Pedicled venous flaps and composite grafts were raised from the abdominal walls of 30 adult New Zealand rabbits. Flap survival was measured and recorded and blood flow studies with microspheres were done for seven days. The viability of the pedicled venous flaps was much better than that of the composite grafts. At two weeks 24 of the venous flaps (80%) showed more than 75% surviving, but 29 (97%) of the composite grafts had less than 25% surviving. The results suggest that the blood flow through a patent vein maintained in a venous skin flap can provide enough nutrients for the flap to survive during the initial three days until neovascularisation. The venous flap receives more blood flow than a composite graft. We conclude that a venous flap depends on blood supply from the axial vein in addition to neovascularisation to maintain its survival.     

大鼠隐血管束全腹壁预制皮瓣模型的实验研究

目的:探讨一种以大鼠隐血管束为预制血管蒂的全腹壁预制皮瓣模型的设计及应用价值。方法:将18只SD大鼠按Ⅰ期手术与Ⅱ期手术之间的间隔时间2、4、6周分为三组。Ⅰ期手术制备大鼠后肢隐血管束预制血管蒂,Ⅱ期手术切开皮瓣四边,形成以预制隐血管束为蒂的岛状皮瓣。Ⅰ期、Ⅱ期术后观察皮瓣血运,记录皮瓣成活面积及成活率。检测Ⅱ期皮瓣血管蒂旁局部组织中血管内皮生长因子(VEGF)含量,取成活皮瓣制作病例切片,HE染色,计算血管密度(血管数/mm2)。运用统计学方法比较各组间差异。结果:Ⅰ期术后各组大鼠腹部皮瓣全部成活;Ⅱ期术后1周,Ⅰ组皮瓣全部坏死,Ⅱ组、Ⅲ组皮瓣平均成活率分别为(14.68±1.02)%,(16.19±1.71)%(P<0.05);Ⅱ期皮瓣局部组织VEGF平均含量:Ⅰ组243.95±4.37,Ⅱ组240.89±3.11,Ⅲ组239.19±2.61(P>0.05);大鼠平均血管密度6周组较4周组略有增多,但差别不大(P>0.05)。结论:大鼠隐血管束全腹壁预制皮瓣模型,可以作为研究提高预制皮瓣成活率的基础,Ⅰ期手术与Ⅱ期手术之间的时间间隔至少需4周。     

End-to-side neurorrhaphy: an experimental study in rabbits

The concept of end-to-side nerve repair was recently introduced; however, most authors have reported conflicting results with this technique. This study was conducted to assess the effectiveness of end-to-side nerve repair in both fresh and predegenerated specimens by histological evaluation in an animal study in rabbits. Thirty male rabbits were divided into three groups. In group 1 (n = 14), the peroneal nerve was divided and sutured end-to-side to the tibial nerve via an epineurial window. In group 2 (n = 13), the peroneal nerve was divided and sutured end-to-side to the tibial nerve after a 1-week "predegeneration period." In group 3 (n = 3), which was considered the control group, the peroneal nerve was divided and sutured to the adjacent soft tissues. After 3 months, specimens were harvested for histological evaluation. Nerve fiber count, in normal peroneal nerves, averaged 532/cross section. In groups 1 and 2, average nerve fiber count in implanted peroneal nerves was 6.24 and 7.00/cross section, respectively. No significant statistical difference was observed between fresh and "predegenerated" groups (P = 0.90). These data suggest that collateral sprouting of donor nerves is possible after end-to-side neurorrhaphy through an epineurial window, but the number of nerve fibers in recipient nerves is too low to result in any functional recovery in the target organ.     

兔延迟术后脂肪瓣内间充质干细胞增殖的实验研究

目的 探讨采用脂肪瓣延迟术等缺血缺氧的方法,促使脂肪来源的兔间充质干细胞(ASCs)增殖的可能性.方法 以兔为动物模型,在一侧腹股沟处形成脂肪瓣.21 d后取出瓣内脂肪组织及对侧正常脂肪组织,消化过筛离心,收集离心后沉淀物中的细胞,用流式细胞仪检测细胞的表面标记,计算细胞CD29、CD44、CD14和CD45的表达率并进行组间比较.结果 脂肪瓣延迟术后,瓣内细胞CD29和CD44的表达率增加,分别为74.06%和90.74%,未经处理的对侧脂肪组织分别为62.88%和77.54%,差异有统计学意义(P<0.05);瓣内细胞CD14和CD45的表达率减少,分别为57.66%和4.84%,未经处理的对侧脂肪组织分别为72.10%和75.82%,差异有统计学意义(P<0.05或P<0.01).结论 脂肪瓣延迟术等缺血缺氧的方法,可促进ASCs的增殖,是用瓣内组织移植后取得更好效果的机制之一;对脂肪组织先进行缺血预处理再移植,可能为一个临床脂肪移植的新方法.     

兔延迟术后脂肪瓣内间充质干细胞增殖的实验研究

目的 探讨采用脂肪瓣延迟术等缺血缺氧的方法,促使脂肪来源的兔间充质干细胞(ASCs)增殖的可能性.方法 以兔为动物模型,在一侧腹股沟处形成脂肪瓣.21 d后取出瓣内脂肪组织及对侧正常脂肪组织,消化过筛离心,收集离心后沉淀物中的细胞,用流式细胞仪检测细胞的表面标记,计算细胞CD29、CD44、CD14和CD45的表达率并进行组间比较.结果 脂肪瓣延迟术后,瓣内细胞CD29和CD44的表达率增加,分别为74.06%和90.74%,未经处理的对侧脂肪组织分别为62.88%和77.54%,差异有统计学意义(P<0.05);瓣内细胞CD14和CD45的表达率减少,分别为57.66%和4.84%,未经处理的对侧脂肪组织分别为72.10%和75.82%,差异有统计学意义(P<0.05或P<0.01).结论 脂肪瓣延迟术等缺血缺氧的方法,可促进ASCs的增殖,是用瓣内组织移植后取得更好效果的机制之一;对脂肪组织先进行缺血预处理再移植,可能为一个临床脂肪移植的新方法.     

兔延迟术后脂肪瓣内间充质干细胞增殖的实验研究

目的 探讨采用脂肪瓣延迟术等缺血缺氧的方法,促使脂肪来源的兔间充质干细胞(ASCs)增殖的可能性.方法 以兔为动物模型,在一侧腹股沟处形成脂肪瓣.21 d后取出瓣内脂肪组织及对侧正常脂肪组织,消化过筛离心,收集离心后沉淀物中的细胞,用流式细胞仪检测细胞的表面标记,计算细胞CD29、CD44、CD14和CD45的表达率并进行组间比较.结果 脂肪瓣延迟术后,瓣内细胞CD29和CD44的表达率增加,分别为74.06%和90.74%,未经处理的对侧脂肪组织分别为62.88%和77.54%,差异有统计学意义(P<0.05);瓣内细胞CD14和CD45的表达率减少,分别为57.66%和4.84%,未经处理的对侧脂肪组织分别为72.10%和75.82%,差异有统计学意义(P<0.05或P<0.01).结论 脂肪瓣延迟术等缺血缺氧的方法,可促进ASCs的增殖,是用瓣内组织移植后取得更好效果的机制之一;对脂肪组织先进行缺血预处理再移植,可能为一个临床脂肪移植的新方法.     

兔延迟术后脂肪瓣内间充质干细胞增殖的实验研究

目的 探讨采用脂肪瓣延迟术等缺血缺氧的方法,促使脂肪来源的兔间充质干细胞(ASCs)增殖的可能性.方法 以兔为动物模型,在一侧腹股沟处形成脂肪瓣.21 d后取出瓣内脂肪组织及对侧正常脂肪组织,消化过筛离心,收集离心后沉淀物中的细胞,用流式细胞仪检测细胞的表面标记,计算细胞CD29、CD44、CD14和CD45的表达率并进行组间比较.结果 脂肪瓣延迟术后,瓣内细胞CD29和CD44的表达率增加,分别为74.06%和90.74%,未经处理的对侧脂肪组织分别为62.88%和77.54%,差异有统计学意义(P<0.05);瓣内细胞CD14和CD45的表达率减少,分别为57.66%和4.84%,未经处理的对侧脂肪组织分别为72.10%和75.82%,差异有统计学意义(P<0.05或P<0.01).结论 脂肪瓣延迟术等缺血缺氧的方法,可促进ASCs的增殖,是用瓣内组织移植后取得更好效果的机制之一;对脂肪组织先进行缺血预处理再移植,可能为一个临床脂肪移植的新方法.     

兔延迟术后脂肪瓣内间充质干细胞增殖的实验研究

目的 探讨采用脂肪瓣延迟术等缺血缺氧的方法,促使脂肪来源的兔间充质干细胞(ASCs)增殖的可能性.方法 以兔为动物模型,在一侧腹股沟处形成脂肪瓣.21 d后取出瓣内脂肪组织及对侧正常脂肪组织,消化过筛离心,收集离心后沉淀物中的细胞,用流式细胞仪检测细胞的表面标记,计算细胞CD29、CD44、CD14和CD45的表达率并进行组间比较.结果 脂肪瓣延迟术后,瓣内细胞CD29和CD44的表达率增加,分别为74.06%和90.74%,未经处理的对侧脂肪组织分别为62.88%和77.54%,差异有统计学意义(P<0.05);瓣内细胞CD14和CD45的表达率减少,分别为57.66%和4.84%,未经处理的对侧脂肪组织分别为72.10%和75.82%,差异有统计学意义(P<0.05或P<0.01).结论 脂肪瓣延迟术等缺血缺氧的方法,可促进ASCs的增殖,是用瓣内组织移植后取得更好效果的机制之一;对脂肪组织先进行缺血预处理再移植,可能为一个临床脂肪移植的新方法.     

兔延迟术后脂肪瓣内间充质干细胞增殖的实验研究

目的 探讨采用脂肪瓣延迟术等缺血缺氧的方法,促使脂肪来源的兔间充质干细胞(ASCs)增殖的可能性.方法 以兔为动物模型,在一侧腹股沟处形成脂肪瓣.21 d后取出瓣内脂肪组织及对侧正常脂肪组织,消化过筛离心,收集离心后沉淀物中的细胞,用流式细胞仪检测细胞的表面标记,计算细胞CD29、CD44、CD14和CD45的表达率并进行组间比较.结果 脂肪瓣延迟术后,瓣内细胞CD29和CD44的表达率增加,分别为74.06%和90.74%,未经处理的对侧脂肪组织分别为62.88%和77.54%,差异有统计学意义(P<0.05);瓣内细胞CD14和CD45的表达率减少,分别为57.66%和4.84%,未经处理的对侧脂肪组织分别为72.10%和75.82%,差异有统计学意义(P<0.05或P<0.01).结论 脂肪瓣延迟术等缺血缺氧的方法,可促进ASCs的增殖,是用瓣内组织移植后取得更好效果的机制之一;对脂肪组织先进行缺血预处理再移植,可能为一个临床脂肪移植的新方法.     

兔延迟术后脂肪瓣内间充质干细胞增殖的实验研究

目的 探讨采用脂肪瓣延迟术等缺血缺氧的方法,促使脂肪来源的兔间充质干细胞(ASCs)增殖的可能性.方法 以兔为动物模型,在一侧腹股沟处形成脂肪瓣.21 d后取出瓣内脂肪组织及对侧正常脂肪组织,消化过筛离心,收集离心后沉淀物中的细胞,用流式细胞仪检测细胞的表面标记,计算细胞CD29、CD44、CD14和CD45的表达率并进行组间比较.结果 脂肪瓣延迟术后,瓣内细胞CD29和CD44的表达率增加,分别为74.06%和90.74%,未经处理的对侧脂肪组织分别为62.88%和77.54%,差异有统计学意义(P<0.05);瓣内细胞CD14和CD45的表达率减少,分别为57.66%和4.84%,未经处理的对侧脂肪组织分别为72.10%和75.82%,差异有统计学意义(P<0.05或P<0.01).结论 脂肪瓣延迟术等缺血缺氧的方法,可促进ASCs的增殖,是用瓣内组织移植后取得更好效果的机制之一;对脂肪组织先进行缺血预处理再移植,可能为一个临床脂肪移植的新方法.     

兔延迟术后脂肪瓣内间充质干细胞增殖的实验研究

目的 探讨采用脂肪瓣延迟术等缺血缺氧的方法,促使脂肪来源的兔间充质干细胞(ASCs)增殖的可能性.方法 以兔为动物模型,在一侧腹股沟处形成脂肪瓣.21 d后取出瓣内脂肪组织及对侧正常脂肪组织,消化过筛离心,收集离心后沉淀物中的细胞,用流式细胞仪检测细胞的表面标记,计算细胞CD29、CD44、CD14和CD45的表达率并进行组间比较.结果 脂肪瓣延迟术后,瓣内细胞CD29和CD44的表达率增加,分别为74.06%和90.74%,未经处理的对侧脂肪组织分别为62.88%和77.54%,差异有统计学意义(P<0.05);瓣内细胞CD14和CD45的表达率减少,分别为57.66%和4.84%,未经处理的对侧脂肪组织分别为72.10%和75.82%,差异有统计学意义(P<0.05或P<0.01).结论 脂肪瓣延迟术等缺血缺氧的方法,可促进ASCs的增殖,是用瓣内组织移植后取得更好效果的机制之一;对脂肪组织先进行缺血预处理再移植,可能为一个临床脂肪移植的新方法.     

兔延迟术后脂肪瓣内间充质干细胞增殖的实验研究

目的 探讨采用脂肪瓣延迟术等缺血缺氧的方法,促使脂肪来源的兔间充质干细胞(ASCs)增殖的可能性.方法 以兔为动物模型,在一侧腹股沟处形成脂肪瓣.21 d后取出瓣内脂肪组织及对侧正常脂肪组织,消化过筛离心,收集离心后沉淀物中的细胞,用流式细胞仪检测细胞的表面标记,计算细胞CD29、CD44、CD14和CD45的表达率并进行组间比较.结果 脂肪瓣延迟术后,瓣内细胞CD29和CD44的表达率增加,分别为74.06%和90.74%,未经处理的对侧脂肪组织分别为62.88%和77.54%,差异有统计学意义(P<0.05);瓣内细胞CD14和CD45的表达率减少,分别为57.66%和4.84%,未经处理的对侧脂肪组织分别为72.10%和75.82%,差异有统计学意义(P<0.05或P<0.01).结论 脂肪瓣延迟术等缺血缺氧的方法,可促进ASCs的增殖,是用瓣内组织移植后取得更好效果的机制之一;对脂肪组织先进行缺血预处理再移植,可能为一个临床脂肪移植的新方法.