机能代偿性皮瓣--快速预制随意皮瓣的实验研究

目的　探讨在 2 4h内使随意皮瓣超范围扩大长宽比例 ,增加皮瓣成活面积的可能性及其限度。方法　选择SD大白鼠 2 0只 ,随机分为实验组 (n =10 )和对照组 (n =10 ) ,按一定方式预制皮瓣 ;实验组行快速预制皮瓣成形训练 ,对照组不训练 ;监控皮瓣微血流灌注值变化过程 ,根据皮瓣微循环参数判断皮瓣血液循环网建立是否成熟。结果　预制皮瓣训练第 18小时皮瓣微循环血流灌注值基本稳定 ,2 4h可完成皮瓣成形术。对照组皮瓣平均成活面积百分率为 (6 8 2 5± 0 18) % ,实验组为 (97 2 5± 0 2 4 ) % ,两组比较差异有显著意义 (P <0 0 1)。结论　在较短的时间里能够建立起超出传统理论极限的随意皮瓣 ,通过数字化判断及监控 ,证明该方法可靠 ,提高了随意皮瓣成活几率

Study in functional compensation of skin flap:an experimental of fast prefabricated random skin flap

OBJECTIVE: To investigate the possibility and the limit in increasing the survival area of the random skin flap by extremely increasing the ratio of its length and width within 24 hours. METHODS: SD rats (n = 20) were chosen for this study. The rats were randomly divided into: subject group and control one. Pre-made skin flap was prepared as design. The subject group was carried out rapid pre-fabricated skin flap formation training. No training was performed in control group. The changes in perfusion value of micro-circulation inside skin flap were monitored during the whole process, and micro-circulation parameters of the skin flap were used to evaluate whether its blood circulation network was mature or not. RESULTS: Training of pre-made skin flap at 18th hour, the perfusion value of its micro-circulation was basically stable, Skin flap formation was finished at 24th hour. Survival area in control group was (68.25 +/- 0.18)% and in subject group was (97.25 +/- 0.24)% (P < 0.01). There was a significant difference between the two groups. CONCLUSIONS: Within short time, it is possible to establish micro-circulation in skin flap which exceeds the limit set by traditional theory. Digitalized judgment can be used to monitor the fast formation of super-big skin flap. This method is reliable and can increase the survival rate of random skin flap.