静脉皮瓣成活过程的实验研究

我们以兔为实验动物，通过微循环观察及血管内灌注填充剂，研究静脉皮瓣的成活过程。这一过程可分为２个阶段。第一阶段（术后７２小时内）为静脉血营养期：静脉血由静脉干通过小静脉吻合支、微静脉干间吻合支及终末微静脉吻合支回流至另一静脉。术后４８小时内毛细血管内无血液运动。第二阶段（术后７２小时～６周）为动脉血营养及血管改造期：术后７２小时新生血管开始向皮瓣内生长。术后７２无皮瓣动脉同主要来自皮瓣周围正常组织内的新生血管吻合使动脉血分布于整个皮瓣，这是静脉皮瓣成活的关键

Experimental study of mechanism of survival of venous flaps

The mechanism of survival of venous flaps was studied by observations employed in the study of microcirculation and blood vessel perfusion in rabbits. Initially,the flap was nourished by venous blood(within 72 hours):venous blood flowed slowly from the principal vein to its tributary veins,and then through the venous anastomoses(including small venous anastomoses,venular anastomoses and terminal venule anastomoses),reaching other tributary veins.No backflow from venules into capillaries was seen.The second stage was arterial nourishing and vessel reconstructive period (72 hours to 6 weeks):new vessels began to grow into the flaps at 72 hours postoperatively.4 days postoperation,arterial flow with low velocity appeared in the primary flap arteries and the backflow of venous blood disappeared.7 days postoperation.the abnormal,flow in,unphysiologic,channels was replaced by the normal flow in,physiologic,channels completely.6 weeks postoperation,the vessel structure of venous flaps was the same as that of normal skin.These results suggested that rich venous network in venous flaps and early invasion of new blood vessels are the mainstay of venous flaps survival.