机能代偿性皮瓣——快速预制随意皮瓣的实验研究

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

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 。

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.