外科延迟对皮神经营养血管蒂岛状瓣成活面积的影响

Research of the Effect and Mechanism of Surgical Delay on the Survival of Neuro-island Flap Based on the Intrinsic Vasculature of Its Cutaneous Nerve

目的(1)探讨皮神经营养血管蒂岛状瓣的活性及外科延迟在促进该类皮瓣成活中的作用;(2)观察延迟后皮瓣组织内微血管的变化。方法设计大鼠腹壁下神经营养血管蒂岛状瓣模型,比较延迟组与非延迟组皮瓣的成活情况;通过透明标本观察延迟后皮瓣组织内微血管的变化。结果即刻掀起的大鼠腹壁下神经营养血管蒂岛状瓣成活面积很小,延迟组皮瓣平均成活面积大于非延迟组(P<0.05)。透明标本观察见延迟后皮瓣组织内血管明显扩张,血管密度增加。结论经外科手术延迟后,单纯以神经营养血管为蒂的岛状瓣能够有较大面积的成活。延迟后皮瓣组织内既存在现有血管的扩张,也有新生血管的形成。

Objective To study whether an acutely elevated skin flap can survive based solely on the intrinsic vasculature of its cutaneous nerve and the effect of the surgical delay on the survival of this kind of flap and the changes of microcirculation of delayed skin flaps. Methods The model of inferior epigastric neuro-island flap based on the intrinsic vasculature of its cutaneous nerve was designed in the rat and the survival of the delayed group was compared with that of the nondelayed group. The changes of microcirculation of delayed skin flaps was observed through HE stain. Results The survived area of the acutely elevated inferior epigastric neuro-island flap based on the intrinsic vasculature of its cutaneous nerve in rat was very small. The average survival percentage of the delayed group was higher than that of nondelayed group （P 〈0.05）. Vasedilatation and neovascularization was observed from the tissue biopsied 3 days after surgical procedure. Conclusion The intrinsic vasculature of cutaneous nerve can supply a bigger flap after surgical delay.