摘要
目的观测猪臀部游离与岛状皮瓣继发性缺血耐受时间。方法臀部岛状皮瓣与游离皮瓣2小时原发性热缺血,12小时再灌注,0、2、4、6、10小时继发性热缺血,7天后测定皮瓣存活率。结果岛状皮瓣可耐受10小时继发性缺血,无皮瓣坏死。游离皮瓣坏死发生率依继发性缺血时间0、2、4、6、10小时为0、10％、50％、80％、100％。另一组实验中,用15μm 微球测量两种皮瓣4小时继发性缺血后皮瓣血流,8个血运障碍的游离皮瓣为对侧岛状皮瓣的8％,其余12个血运正常的游离皮瓣是岛状皮瓣的76％。结论猪臀部游离皮瓣的继发性缺血耐受时暗短于岛状皮瓣,与皮瓣低血流相关。
Objective This study was to compare skin viability of the free skin flap and the is- land skin flap in the pig.Methods The comparison was made between the 8cm×11cm surgically dener vated free skin flap and the pedicle island skin flap raised contralaterally on the buttock of 50 pigs.The free flap and the pedicle flap were subjected to 2h of primary warm ischemia followed by 12h of reperfu- sion and 0,2,4,6,10h of secondary warm ischemia (n=10).Skin viability was assessed 7 days after sec- ondary ischemia.Results Pedicle skin flaps tolerated up to 10h secondary ischemia without skin necro- sis.However,incidences of flap failure (partial or total) in free flaps subjected to 0,2,4,6,10h of sec- ondary ischemia were 0,10%,50%,80%,100%,respectively.In a separate experiment,skin blood flow was studied in contralateral free skin flaps and pedicle island flaps (n=20) subjected to 4h of secondary ischemia.The skin reperfusion was very slow in 8 out of 20 free skin flaps at 1.5h after secondary is- chemia,and the mean skin blood flow measured by 15μm microspheres in these 8 free skin flaps was only 8% of their contralateral pedicle skin flaps.The mean skin blood flow in the remaining 12 free skin flaps was 76% of their contralateral pedicle skin flap.Conclusion These observations were interpreted to in- dicate that buttock free skin flaps in the pig were less tolerant to secondary ischemia compared with their contralateral pedicle skin flaps subjected to the same ischemic protocol,and this reduced ischemic tolerance in free skin flaps was associated with compromised skin blood flow.
关键词
显微外科
缺血
耐受时间
微球
皮瓣
Microsurgery
Ischemic tolerance
Microsphere
Flap
