CAJ | 학술논문

目的建立不同单一穿支血管蒂皮瓣的动物模型,探讨单一穿支血管所能营养的最大的皮肤范围.方法选择36只雄雌不限的SD大鼠,分成A、B、C3组,每组12只,以大鼠背部双侧肩胛骨顶点连线为上界、双侧髂棘连线下1 cm处为下界,分别以旋髂深动脉穿支(DCIA)、后肋间动脉穿支(PIA)及侧胸动脉穿支(LTA)为蒂,设计13 cm×6 cm皮瓣,术后72 h体内注射荧光素钠观察皮瓣染色情况,术后7d观察记录皮瓣成活情况,氧化铅明胶造影显示皮瓣血管结构.结果 C组及A组皮瓣远端无荧光染色,B组整个皮瓣出现荧光;C、A、B各组皮瓣的成活率依次增高,组间差异有统计学意义(P＜0.01);A组氧化铅明胶造影显示皮瓣头端坏死区域LTA血管结构部分消失,B组显示各供区血管结构清晰,C组显示尾端坏死区域DCIA血管结构部分消失及紊乱.结论以单一穿支血管蒂为中心可放射性地完整带动其周围多个第2血管供区,第3血管供区远端坏死,在一个方向上血供能到达的最远距离是第3血管供区的穿支入皮点,这对临床上设计穿支皮瓣具有一定理论指导作用.
목적 건립불동단일천지혈관체피판적동물모형,탐토단일천지혈관소능영양적최대적피부범위.방법 선택36지웅자불한적SD대서,분성A、B、C3조,매조12지,이대서배부쌍측견갑골정점련선위상계、쌍측가극련선하1 cm처위하계,분별이선가심동맥천지(DCIA)、후륵간동맥천지(PIA)급측흉동맥천지(LTA)위체,설계13 cm×6 cm피판,술후72 h체내주사형광소납관찰피판염색정황,술후7d관찰기록피판성활정황,양화연명효조영현시피판혈관결구.결과 C조급A조피판원단무형광염색,B조정개피판출현형광;C、A、B각조피판적성활솔의차증고,조간차이유통계학의의(P＜0.01);A조양화연명효조영현시피판두단배사구역LTA혈관결구부분소실,B조현시각공구혈관결구청석,C조현시미단배사구역DCIA혈관결구부분소실급문란.결론 이단일천지혈관체위중심가방사성지완정대동기주위다개제2혈관공구,제3혈관공구원단배사,재일개방향상혈공능도체적최원거리시제3혈관공구적천지입피점,저대림상상설계천지피판구유일정이론지도작용.
Objective To develop a new experimental animal model of different a single perforating vessel as its pedicle,and to investigate this vessel can captures how many adjacent angiosomes in different directions.Methods Thirty-six Sprague-Dawly rats of both sexes were used.The rats were divided into group A,group B and group C.Group A:the unilateral deep circumflex iliac perforator arterybased flap.Group B:the unilateral posterior intercostal perforator artery-based flap.Group C:the unilateral lateral thoracic perforator artery-based flap.An extended dorsal perforator flap measuring up to 13 cm × 6 cm was designed in 36 rats to assess the viability of the flap.The upper margin was located at the level of the tip of the scapula and the lower margin at a level 1 cm below the iliac crest.All flaps were observed for 7 days postoperatively,72 hours after flap elevation,observe flap dyeing conditions through the vivo fluorescein injection,the surviving flap area was calculated as a percentage of total flap dimensions and the angiosome's structure of the flap was displayed by radiopaque microangiography.Results No fluorescence was visible in the distal flap of groups A and C,the whole flap show bright fluorescence in group B.Survival rate of C,A,B were improved in order.Statistic difference is significant (P ＜ 0.01) between group and group.In group A,lead oxide-gelatin angiography shows the cephalic flap necrosis occurred in the bilateral lateral thoracic territories,and the vascular architecture partly disappeared in the necrotic area.In group B,the vascular architecture of flap is unbroken.In group C,the caudal flap necrosis occurred in the bilateral deep circumflex iliac perforator artery territories,and the vascular architecture partly disappeared and disordered in the necrotic area.Conclusions The perforator flap is based centrally on a single perforator,this vessel can capture multiple the second vascular territory.In a direction,the longest distance that the blood supply can reach is the point of the third perforator vessel puncture into skin,which can provide certain theoretical guidance for designing of perforator flap.