外用罂粟碱霜对扩张皮肤血流量及扩张皮瓣成活长度的影响

目的　探讨外用罂粟碱霜对扩张皮肤的血流量及对扩张皮瓣成活长度的影响。方法　以小型猪为实验动物 ,将罂粟碱霜用于组织扩张过程 ,分别与罂粟碱全身给药和囊内导入 2种方式以及常规扩张进行对照 ,观察在扩张前后及给药前后扩张皮肤的组织血流量以及扩张皮瓣成活长度的差异。结果　扩张注水前外用组皮肤血流量值较其它组明显较高 (P <0 .0 5)。在扩张后外用组较其它各组仍处于较高水平 (P <0 .0 1 ) ;给药前外用组皮肤血流量值较其它 2组高 (P <0 .0 5) ;外用组在给药后 ,扩张皮肤的血流量值不断上升并最终高于其它各组 ,至 2 4 0分钟时与其它各组明显差异 (P <0 .0 5) ;术后 1 0天外用组平均皮瓣成活长度为 (1 3 .67± 1 .2 8)cm ,导入组为 (1 1 .0 7± 0 .88)cm ;肌注组为 (1 0 .79± 0 .49)cm ,对照组为 (9.49± 0 .77)cm ,外用组与其它各组之间差别均非常显著 (P <0 .0 1 ) ;外用组扩张包膜组织中罂粟碱的平均含量为 (3 .5± 1 .2 ) μg/g,导入组和肌注组包膜组织中及各组动物血液中均检测不到罂粟碱含量。结论　外用罂粟碱霜剂能够透过皮肤并有效地发挥扩张血管的作用 ,从而增加扩张皮肤的血流量 ,增加扩张皮瓣的成活长度。对于扩大组织扩张术的应用范围、减少并发症、提高手术效果有重要的应用价     

外用罂粟碱霜对扩张皮肤血流量及扩张皮瓣成活长度的影响

目的探讨外用罂粟碱霜对扩张皮肤的血流量及对扩张皮瓣成活长度的影响.方法以小型猪为实验动物,将罂粟碱霜用于组织扩张过程,分别与罂粟碱全身给药和囊内导入2种方式以及常规扩张进行对照,观察在扩张前后及给药前后扩张皮肤的组织血流量以及扩张皮瓣成活长度的差异.结果扩张注水前外用组皮肤血流量值较其它组明显较高(P＜0.05).在扩张后外用组较其它各组仍处于较高水平(P＜0.01);给药前外用组皮肤血流量值较其它2组高(P＜0.05);外用组在给药后,扩张皮肤的血流量值不断上升并最终高于其它各组,至240分钟时与其它各组明显差异(P＜0.05);术后10天外用组平均皮瓣成活长度为(13.67±1.28)cm,导入组为(11.07±0.88)cm;肌注组为(10.79±0.49)cm,对照组为(9.49±0.77)cm,外用组与其它各组之间差别均非常显著(P＜0.01);外用组扩张包膜组织中罂粟碱的平均含量为(3.5±1.2)μg/g,导入组和肌注组包膜组织中及各组动物血液中均检测不到罂粟碱含量.结论外用罂粟碱霜剂能够透过皮肤并有效地发挥扩张血管的作用,从而增加扩张皮肤的血流量,增加扩张皮瓣的成活长度.对于扩大组织扩张术的应用范围、减少并发症、提高手术效果有重要的应用价值.     

应用带导药系统的扩张器加速扩张的临床研究

目的　探索加快组织扩张速度和提高皮瓣扩张质量的新型扩张方法。方法　对 16例患者不同部位应用带导药系统的新型扩张器进行皮肤软组织扩张 ,在扩张的同时导入罂粟碱。结果　NEM(newexpansionmethod ,新型扩张法 )和GEM(generalexpansionmethod ,常规扩张法 )扩张至额定容量所需要的平均时间分别为 2 6d和 5 1d ;全部扩张完成后两种扩张法扩张器的实际注水量超过额定容量的百分比分别为 92 .41%和 2 7.12 %。扩张后扩张区皮肤血流量是 (v) :NEM :1.2 7± 0 .2 8;GEM :0 .6 4± 0 .11。表面积即时回缩率的比较为 :NEM :2 0 .17± 1.74;GEM :38.2 6± 2 .0 1。结论　采用NEM方法 ,扩张速度快 ,皮瓣的即时回缩率低 ,血运好。     

外用罂粟碱抑制植皮片术后挛缩的实验研究

目的探讨外用罂粟碱霜对自体游离植皮片术后晚期挛缩的影响。方法在每头小型猪背部两侧皮肤制备10个2cm×2cm创面,从动物腹部正中取2cm×2cm的断层皮片并植于背部创面上,术后2周拆线,取同一动物身上100%成活且位置恰好左右侧相对的植皮片共12对,按左右侧分成A(罂粟碱治疗组)、B(空白霜剂对照组)2组,自拆线之日起,A组每日在植皮片表面外涂2%罂粟碱霜2次,B组仅涂抹空白对照霜剂,最后观察两组植皮片成活后1、2、3、4、5、6个月收缩率及植皮片成活后6个月时的组织学差异。结果A组植皮片收缩率较B组明显降低,两组之间差异有显著性意义(P<005)。组织切片显示A组植皮片成纤维细胞较B组明显减少,微血管数量较B组数量多,两组之间差异有显著性意义(P<005)。结论外用罂粟碱霜剂能够抑制自体游离植皮片术后挛缩,提高植皮效率。     

二种胰肠吻合术吻合口创伤愈合的实验研究

目的　观察比较两种胰肠吻合方法创伤愈合过程。　方法　按吻合方法不同将动物分为捆绑式胰肠吻合组 (Ⅰ组 )和套入式胰肠端端吻合组 (Ⅱ组 ) ,分别在术中、术后 5、10d活体测定吻合口破裂压和离断力 ,并做病理观察。　结果　 (1)破裂压 :Ⅰ组 ,0、5、10d分别为 (139 7± 8 0 )mmHg、(178 7± 9 7)mmHg和 (2 6 8 8± 12 8)mmHg ,Ⅱ组则为 (6 7 3± 7 9)mmHg、(96 2± 10 4 )mmHg和 (130 6± 9 3)mmHg。Ⅰ组和Ⅱ组在 0至 5d和 5至 10d两时间段分别增加 2 7 9%、5 0 5 %和 4 2 9%、35 7% ,两组间在 0、5、10d时差异具有非常显著性 (P <0 0 1)。 (2 )离断力 :Ⅰ组 ,0、5、10d分别为 (4 5± 0 4 )N、(6 6± 0 4 )N和 (10 0± 0 6 )N ;Ⅱ组为 (4 6± 0 6 )N、(5 8± 0 5 )和 (7 1± 0 6 )N。两组在 0天时基本相同 ,但Ⅰ组在 0至 5d和 5至 10d两时间段有较快增长(44 8%和 5 2 9% ) ,两组间在 5、10d时差异具有显著和非常显著性 (P <0 0 5和P <0 0 1)。 (3)组织病理学 :Ⅰ组在 10d时吻合口已由结缔组织基本修复 ,胰腺残端断面已基本由黏膜上皮覆盖。而Ⅱ组则由肉芽组织不完全修复 ,胰腺残端断面尚无上皮再生。　结论　捆绑组 (Ⅰ组 )吻合口强度更强 ,愈合更快。     

一种小型猪全层皮肤缺损创面模型的制备与应用

目的　建立一种小型猪全层皮肤缺损创面模型 ,并用此模型研究碱性成纤维细胞生长因子 (bFGF)对创面愈合的作用。方法　小型猪背部剃毛 ,用特制致伤器 (直径 1 8mm打孔器 )在背部脊柱两侧垂直于皮肤向下钻至深筋膜 ,剪去已钻掉的皮肤 ,形成全层皮肤缺损创面。将创面分为bFGF治疗和空白对照两组 ,测定伤后不同时间创面面积、伤腔容积及进行创面组织病理学检查。结果　伤后 3、7dbFGF治疗组创面面积缩小到 (1 .81± 0 .1 5)cm2 、(0 .51± 0 .1 0 )cm2 ,明显小于空白对照组的 (2 .0 0± 0 .2 1 )cm2 、(0 .61± 0 .1 1 )cm2 (P <0 .0 5) ;伤腔容积缩小到 (0 .49± 0 .0 7)ml、(0 .0 2± 0 .0 4 )ml,也小于空白对照组的 (0 .61± 0 .1 7)ml、(0 .1 4± 0 .1 6)ml(P <0 .0 5)。伤后1 4d组织病理学检查可见bFGF组大部分创面上皮化 ,而空白对照组较多的创面未愈合。结论　经特制致伤器制备的小型猪全层皮肤缺损创面模型简便、快速 ,创面之间具有较好的均衡性 ,是研究外用药物促进创面修复作用的较理想模型之一 ,bFGF具有促进创面修复的作用     

经肝动脉或瘤体注射单纯疱疹病毒-胸苷激酶基因治疗兔肝癌

目的　观察瘤体内直接注射或经肝动脉注射载有单纯疱疹病毒胸苷激酶 (HSV TK)基因的EB病毒表达质粒 pDR2 /TK、丙氧鸟苷 (GCV )对原位兔肝癌的治疗效果。 方法　制作兔原位肝癌模型 (VX2 ) ,瘤体注射或经肝动脉注射质粒 pDR2 /TK ,腹腔注射GCV连续 10d。RT PCR检测肝癌HSV TK表达 ;螺旋CT监测肝癌大小 ,并观察兔存活时间。结果TK基因导入 10d后 ,直接注射组TK在肝癌组织强表达 ,癌旁组织弱表达 ,正常肝组织不表达 ;肝动脉注射组TK基因在肝癌表达稍强于癌旁及正常肝组织。直接注射组肿瘤大小 ( 3 .5 5± 0 .3 9)cm ,与经肝动脉注射+肝动脉结扎组肿瘤大小 ( 3 .70± 0 .3 7)cm无明显差别 (P >0 .0 5 ) ,但均明显小于对照组。瘤体直接注射TK基因 +GCV治疗组动物平均存活时间 ( 5 9.8± 3 .3 )d、肝动脉注射组 +肝动脉结扎组( 5 4.8± 4.5 )d明显长于各对照组 (P均 <0 .0 1)。结论　对实验性兔肝癌 ,瘤体内直接注射或经肝动脉注射导入治疗基因后 ,HSV TK/GCV系统具有较好的治疗效果。     

早期肾癌保肾手术切除范围的探讨

目的　探讨直径 4cm以下肾癌保肾手术的安全切除范围。　方法　直径≤ 4cm肾癌根治术标本 82例 ,标本分层切开 ,确定多中心病灶 ,假包膜外 15mm范围连续取材确定假包膜完整性及可能存在的假包膜外癌性浸润灶 ,并测量包膜外癌灶与原发灶的最大距离。采用免疫组织化学技术检测 41例直径≤ 4cm肾癌的增值细胞核抗原 (PCNA)蛋白表达 ,其中假包膜外癌灶阳性组 8例 ,阴性组 3 3例。　结果　 82例肾癌平均直径 (3 4± 0 8)cm (1 5～ 4 0cm)。其中 3 1 7% (2 6/82 )缺乏完整假包膜 ,17 1% (14/82 )存在 1种以上假包膜外癌灶 ,其中肾实质浸润 8例 ,小静脉癌栓 2例 ,多中心病灶 4例。假包膜外癌灶与原发灶距离平均 (0 5± 1 3 )mm ,95 %可信区间 (0 11,0 94)。取单侧百分位数P95为 4 9mm ,P97 5、P10 0 均为 5 0mm。 41例肾癌平均PCNA指数为 (2 9 5± 17 6) % (5 5 %～85 6% ) ,其中阳性组为 (49 6± 2 1 5 ) % ,明显高于阴性组 (2 4 6± 12 7) % (t=3 162 ,P =0 0 13 )。阳性组 8例中 ,PCNA高表达 5例 ,而阴性组 3 3例中 ,高表达率仅 18 2 % (6/3 3 ) ,(χ2 =6 44 2 ,P =0 0 11)。结论　直径≤ 4cm肾癌保肾手术安全切缘须包括假包膜外 5mm以上的正常肾实质。单纯肿瘤剜除术易造成肿瘤残留及局部复发     

他克莫司和来氟米特合用抑制大鼠心脏移植排斥反应及T淋巴细胞增殖

目的　评价他克莫司 (FK5 0 6 )和来氟米特联合应用对大鼠心脏移植排斥反应的抑制作用。方法　将实验动物随机分为对照组、FK5 0 6组、来氟米特组以及FK5 0 6与来氟米特合用组 ,观察移植心存活时间 ,于术后 7d切取部分移植心做病理检查 ,并测定各组受者外周血T淋巴细胞亚群及肝、肾功能。结果　不用免疫抑制剂的对照组移植心存活时间为 ( 7.14± 1.0 7)d ,单用FK5 0 6的组为( 11.14± 1.73)d ,单用来氟米特的组为 ( 11.2 9± 1.80 )d ,两药合用组为 ( 14 .0 0± 2 .4 9)d ,合用组的病理切片提示排斥反应明显轻于两药单用组。术后 7d ,合用组外周血T淋巴细胞亚群中 ,CD4 +细胞明显低于两药单用组 (P <0 .0 5 ) ,而CD8+细胞各组间的差异无显著性 ;各组间肝、肾功能的差异也无显著性。结论　FK5 0 6和来氟米特联合应用对大鼠心脏移植的免疫抑制作用优于相同剂量的单一用药     

人内皮抑素转基因治疗裸鼠人大肠癌

目的　研究瘤内注射携带人内皮抑素 (hEN)基因的SA脂质体对裸鼠体内大肠癌LoVo细胞生长的抑制作用。方法　克隆、修饰hEN并构建真核表达质粒pcDNA3 hEN ,2 0 μg质粒加 40 μgSA脂质体构建SA pcDNA3hEN。 3 2只裸鼠背部皮下注射 2× 10 5/mlLoVo细胞悬液建立人大肠癌裸鼠模型。随机分 4组分别瘤内注射NS、SA、SA pcDNA3和SA pcDNA3hEN后 4、8、12、16d测量肿瘤体积。结果　SA pcDNA3hEN组肿瘤平均体积均小于对照组 ,第 12、16天的平均体积分别为 (0 .2 7± 0 .2 1)cm3 及 (0 .5 7± 0 .41)cm3 ,而对照组肿瘤体积为 :NS组 (0 .89± 0 .3 9)cm3及 (2 .5 0± 0 .91)cm3 ;SA组 :(0 .98± 0 .69)cm3 及 (1.98± 0 .5 9)cm3 ;SA pcDNA3组 :(0 .90± 0 .3 4)cm3 及 (1.88± 1.0 2 )cm3 ,差异有显著性 (P <0 .0 5 )。结论　瘤内注射携带hEN基因的SA脂质体可抑制裸鼠体内种植性人大肠癌的生长。     

外用盐酸罂粟碱抑制植皮片术后挛缩作用机理的实验研究

目的：探讨外用盐酸罂粟碱抑制植皮片术后挛缩的作用机理。方法：取18只大鼠36侧移植皮片作为实验对象,将大鼠分成测量组及取材组,同一只大鼠的植皮片按左右侧对应位置进行配对,分成A（罂粟碱治疗组）、B（空白霜剂对照组）2组。A组每日在植皮片表面外涂2％罂粟碱霜2次,B组仅涂抹空白对照霜剂,术后90天后,A、B两组改为全部应用空白霜剂。最后观察两组术后10、20、40、60、90、120天收缩率变化及α-SMA免疫组化染色、天狼猩红染色的组织学变化。结果：外用盐酸罂粟碱霜可以有效地抑制大鼠植皮片术后挛缩,免疫组化染色显示：应用盐酸罂粟碱霜后,皮片创面中的肌成纤维细胞（MFB）数量较对照组明显减少。天狼猩红染色显示用药组皮片的Ⅰ／Ⅲ型胶原比值较用药组降低。结论：外用罂粟碱霜剂能够抑制自体游离植皮片术后挛缩,其作用机理在于盐酸罂粟碱可以明显减少皮片下肌成纤维细胞（myofibroblast MFB）的数量并降低Ⅲ／Ⅰ型胶原比值从而抑制了植皮片的挛缩。     

扩张囊外纤维包膜的组织学结构及其意义

目的研究扩张囊外纤维包膜的组织结构和转归.方法用12只白色小家猪制作常规间断扩张(CITE)和持续恒压扩张(CPTE)动物模型,取纤维包膜做测量和组织学检查.结果CPTE纤维包膜的组织厚度和收缩率明显小于CITE组(P＜0.05).纤维包膜有4层结构,其中含大量的胶原纤维和弹力纤维,另含有发育良好的小动脉、小静脉和毛细血管.皮瓣移植后,皮瓣侧纤维包膜大部退化,弹力纤维层和纤维板层仍存.创基侧的纤维包膜则基本完全退化.结论纤维包膜具有收缩和供血能力.去纤维包膜可减轻皮瓣回缩,但制作较大的扩张皮瓣最好保留纤维包膜.扩张器底部的纤维包膜可不处理.     

The effects of theophylline and papaverine in enhancing skin expansion in guinea pigs

Summary The present study was designed to assess the effectiveness of Papaverine and Theophylline for the enhancement of tissue expansion. Twentyfour guinea pigs were evenly assigned to three groups. One group served as control, the other two were experimental. In one group, Papaverine was used for enhancement of tissue expansion, in the other, Theophylline. It was assumed that by using anticontractile agents, formation of the fibrous capsule around the expander could be inhibited, thus enhancing tissue expansion. The study revealed that the rate of expansion was significantly increased with the use of either agent, but it appears that there is no significant difference in the effectiveness of the two agents.     

维持扩张期对扩张皮肤张力和即时回缩率影响的研究

目的：研究维持扩张期对扩张皮肤在体张力和即时回缩率的影响，并以此指导临床。方法：以狗为动物模型，在6只成年大狗的背侧，对称设计6个区域。实验分为注水2周组、6周组、实验对照组和空白对照组。分析比较各组的在体张力和即时回缩率（包括有包膜和去包膜）。结果：皮肤在体张力和即时回缩率随着维持期的延长逐渐缩小，而注水期的长短对其影响不大；去除包膜后皮肤的在体张力和即时回缩率明显降低。在此基础上，临床应用16例23个扩张器的效果较好。结论：在皮肤软组织扩张术中，可以通过缩短注水期（2周左右）、适当延长维持期（4周）以及去包膜的方法，可以达到减少扩张皮肤的在体张力和即时回缩率，增加扩张皮肤面积的目的。     

带导药系统的快速扩张器的临床研究

目的探索快速组织扩张和提高皮瓣扩张质量的方法.方法对15例不同部位应用带导药(罂粟碱)系统的扩张器进行皮肤软组织扩张.结果新型扩张法(下简称NEM)和普通扩张法(下简称GEM)扩张至额定容量所需要的平均时间分别为26d和51d;全部扩张完成后两种扩张法扩张器的实际注水量超过额定容量的百分比分别为92.41%和27.12%.扩张区皮肤血流量的比较(V),NEM1.27±0.28;GEM0.64±0.11.扩张表面积即时回缩率的比较(%),NEM20.17±1.74;GEM38.26±2.01.结论采用此种方法,扩张速度快,皮瓣的即时回缩率低,血运好.     

Evaluation of clinically applicable exsanguination treatments to alleviate venous congestion in an animal skin flap model

This study compares the effectiveness of alleviating venous congestion with mechanically-made outlets or leech therapy in promoting skin flap survival. Free flaps of abdominal skin (3 x 6 cm) were raised on Sprague-Dawley rats and subjected to ischemic events, simulating venous congestion. Animals received 1) no treatment; 2) two treatments involving two 18-gauge needle-puncture outlets; or 3) two sessions of leech therapy. Flap perfusion was monitored with a scanning laser Doppler flowmeter. Photographic images of flaps at 7 days were assessed for areas of normal tissue (n = 15), and laser Doppler flowmeter data consisted of control (n = 6), outlet (n = 6), and leech (n = 7). Both the needle-puncture outlet (40.0% +/- 9.24%) and leech treated (34.6% +/- 7.34%) groups had a significantly greater surviving skin area than untreated control flaps (8.0% +/- 5.0%), with 2 of 15 flaps receiving mechanical outlets exhibiting > 90% surviving area. After 7 days, laser Doppler flowmeter data showed greater mean perfusion in the outlet (71.7% +/- 16.8%) and leech (92.6% +/- 17.2%) treated groups, compared to controls (15.2% +/- 10.2%). There was a significant increase in perfusion in the outlet (13.3% +/- 6.2%) and leech (9.1% +/- 1.1%) treated groups from the end of secondary ischemia to day 7 (p < 0.05) compared to controls. The results suggest that two spatially separated outlets are as effective as one leech in increasing the area of surviving skin in venous congested flaps.     

Hemodynamics in skin and tissue expansion]

The capillary blood flow (CBF) of the random flaps constructed on expanded and unexpanded skin of dogs was determined by radioactive microsphere technique. The CBF was significantly higher (P < 0.001) in the skin flaps of the expanded group (387 +/- 23 microliters/min/flap) than that of the acute group (127 +/- 16 microliters/min/flap). There were no significant differences in the expanded group, the delayed group (374 +/- 35 microliters/min/flap) and the control group (389 +/- 48 microliters/min/flap). Even at the pedicle site, the CBF of the acute group was already significantly lower than that of other three groups (P < 0.001). The general tendency of gradual CBF reduction from the pedicle to the distal end of all the flaps was observed. The CBF at the point 8cm from the pedicle of the acute group was 12 microliters/min/g, whereas in other three groups, at point 13 cm from the pedicle the CBF was 12 microliters/min/g. The results suggested that during skin expansion the area of skin is enlarged, and its CBF and survival length may be increased. The problem of capsulectomy during flap construction was discussed.     

Improvement of length of survival of expanded flap by application of topical papaverine cream

Abstract

Blood flow in expanding tissue can be improved by papaverine through a special delivery system in early report. Because the delivery system was complex and inconvenient, another way of using papaverine was tested to observe the blood flow and the survival length of expanded flap in this study. Twenty-four pigs were divided into three groups randomly named A, B, and C. Four soft tissue expanders (150 millilitres) were implanted into each pig in group A and C. Another four modificatory rectangular expanders were implanted into each pig in group B. A laser Doppler blood velocimeter was used to measure the blood flow. During the expanding process, 1 gram (containing 2% hydrochloride papaverine) of hydrochloride papaverine cream was applied topically on the surface of each expanding skin in group A twice daily. Two millilitres of hydrochloride papaverine (containing 30 milligrams of hydrochloride papaverine) solution was injected into each outer shell of the modificatory expander in group B weekly. Group C acted as control group. A 15 × 3 centimetre random flap was evaluated from the expanded skin after expanding and the survival length measured. The value of blood flow increased more significantly in group A than groups B and C. There were statistical differences. The survival length of the expanded flap in group A was the longest among the three groups, and there were statistical differences too. This study shows that the survival length of expanded flap can be increased by application of papaverine cream topically during the expanding process.     

Subperiosteal tissue expansion: an experimental study

Periosteal flaps have been used to cover bone defects. There are no sufficient data on whether expanded periosteum can be used to repair bone defects after subperiosteal tissue expansion. In this experimental study, 14 male dogs, which were 2 years-old and weighed 14.5–16.0 kg, were used to investigate the repair of bony defects with expanded periosteum. Rectangular tissue expanders, measuring 50 mm in width, 70 mm in length, and 20 mm in height (volume: 20 ml) were used. The dogs were divided into two groups each of seven dogs: one control group and one experimental group. In each dog, a pocket, 50×70 mm in size, was prepared in parietal area, and a periosteal area, 30×40 mm in size, was marked out. A rectangular tissue expander was inserted into the pocket. In the control group, the tissue expanders were not inflated. On the seventh postoperative day, the tissue expander inflation with normal saline (5 ml per 2 days) was started in the experimental group. After 15 days, the previously marked out periosteal area was measured. A specimen was taken from this periosteal tissue for histopathological evaluation. A bone defect, 20×20 mm in size, was created beneath expanded periosteal tissue, and this defect was covered with the expanded periosteal tissue. After 15 days, a histopathological evaluation was carried out. Statistical analysis was carried out using the Mann–Whitney U-test. The area of periosteum expanded was more in the experimental group than that of the control group (p>0.05). After removal of the tissue expander, both in the control and subperiosteal tissue expansion group, osteoblastic lining of the expanded periosteum, increased vascularity, and granulation tissue was noted. Following 15 days, woven and lamellated bone tissue was formed both in the control and subperiosteal expansion group. In the subperiosteal expansion group, there was greater bone formation, the expanded periosteum was thickened, and thickened lamellated bone was covered by active osteoblasts. It is concluded that subperiosteal tissue expansion may be worthwhile to provide large periosteal flaps for the repair of large bone defects, by increasing osteogenic capacity.     

Comparative viability of expanded and unexpanded axial pattern skin flaps in pigs

A comparison of viable areas of axial pattern flaps post inset was made between expanded and non-expanded pig buttock island flaps. The deep circumflex iliac artery and vein supply approximately the proximal 14 x 10 cm area of this flap. Larger flaps were raised on expanded and control sides of eight pigs to determine if expansion increased the area of survival. In six of eight pigs whose initial tissue expansion did not create more than approximately a 50% increase in skin area, the expanded flaps had a statistically significant increase in viable skin area (proportionally) 10 days post inset than their control flaps (p less than 0.05). Two other pigs did not conform to this pattern. Their initial tissue expansion was greater than 50%, and the resulting area of flap viability was proportionally less in expanded flaps than the control flaps.