浅静脉干对四肢远端蒂皮瓣作用的实验研究

Role of large superficial veins in distally based flaps of extremities

目的 :研究浅静脉干在远端蒂皮瓣中的作用。方法 :在 5只犬的两侧前肢设计 10个包含头静脉的远端蒂岛状筋膜皮瓣 (8cm× 2cm) ,随机分成蒂部浅静脉干结扎组 (实验 )和不结扎组 (对照 ) ,进行浅静脉干测压和皮瓣成活面积测定。结果 :远端蒂皮瓣掀起后 ,浅静脉干压力在 4.6 7～ 5 .6kPa(35～ 42cmH2 O) ,超过毛细血管动脉灌注压 4.0kPa(30cmH2 O)。蒂部浅静脉干结扎后 ,远端蒂皮瓣的成活面积(15 .6± 0 .5 5 )cm2 ,占皮瓣面积的 97.5 % ,其成活质量显著优于不结扎组 (11.6± 2 .0 7)cm2 ,占皮瓣面积的72 .5 %。结论 :浅静脉干对远端蒂皮瓣的成活有害无益 ,临床上应在远端蒂部将其分出结扎。

Objective:To study the effects of large superficial veins in distally based flaps .Methods:Ten distally based fasciocutaneous island flaps (8 cm×2 cm) with cephalic vein were raised in 5 dogs in the forelimb.In experimental group (5) the large superficial vein was dissected and ligated at the distal base,but in the control group (5) it was not.Pressures in large superficial veins and area of survival flap were measured in two groups.Results:After flap was elevated and pneumatic tourniquen was released,pressure of cephalic veins increased rapidly and then maintained at 4.67 kPa to 5.6 kPa ,which was much higher than arterial capillary pressure (4.0 kPa).Survival quality and area of flap in experiment group (15.6±0.55 cm 2,97.5%) was much better and larger than control group (11.6±2.07 cm 2, 72.5%) .Paired student's test showed statistically a significant difference between the two groups ( P < 0.05) .Conclusion:Larger superficial veins play a negative leading role in the survival of distally based flaps.In clinic,it should be ligated at the distal base.