微循环灌注压重建对皮瓣成活面积影响的实验研究  

An Experimental Study for Effect of Reconstruction of Microcirculation Perfusion on Survival Area of Random Flap

作　　者：余道江[1] 赵天兰[1] 徐又佳[1] 张治华[1] 伍丽君[1] 徐子寒[1] 冀宇[1] 

机构地区：[1]苏州大学附属第二医院整形外科,江苏省苏州市215004

出　　处：《中华全科医学》2011年第10期1498-1500,F0003,共4页Chinese Journal of General Practice

基　　金：江苏省苏州市青年科教兴卫项目(SWKQ0915)

摘　　要：目的探讨应用负压封闭引流技术(VSD)对皮瓣成活面积的影响。方法 SD大鼠40只,随机分为5个组:1天组、2天组、3天组、4天组和6天组,即在每只大鼠的背部两侧各设计制作1块皮瓣,一侧为对照侧,另一侧为实验侧,皮瓣设计为:蒂宽=蒂长=0.8 cm,蒂部所携带直径为3.5 cm的皮瓣,形状类似"乒乓球拍";皮瓣形成后给予实验侧皮瓣上安装负压封闭引流装置。各个组分别于手术后1 d、2 d、3 d、4 d和6 d观察皮瓣颜色、肿胀程度,切取0.3 cm×0.5 cm标本,第7天测量皮瓣成活面积。通过HE染色、免疫组化等,进行皮瓣组织学、CD34表达情况的观察。结果①负压封闭引流技术改善皮瓣淤血水肿,促进皮瓣成活,3 d达到最大成活面积。②负压封闭引流技术促进皮瓣微血管密度增大,促进血管新生。结论负压封闭引流技术重建皮瓣远端组织的微循环灌注压可改善皮瓣缺血缺氧状态,扩大皮瓣成活面积。Objective To discuss the effect of the reconstruction of microcirculation perfusion of the distal end tissue（ischemic and hypoxic tissue） on the survival area of random flap by application of vacuum sealing drainage（VSD）.Methods 40 SD rats were divided into 5 groups in random.A flap was designed and put on either side of a rat＇s back,and the flap was designed in the shape of a table tennis.The width and the length of the flap were both 0.8 cm and the pedicle was with the diameter of 3.5 cm.And the flaps on one side of the rats＇ backs were randomly arranged into control group,and the flaps on the other side served as the experiment group.The 5 groups divided at first were named respectively after the time of the experiment：the one-day group,the two-day group,the three-day group,the four-day group,and the six-day group.And the control group and the experiment group were further divided within each of these eight groups.That was to say,each time the control groups had eight flaps.So did the experiment groups.The equipment of VSD was fixed sideways to each group after the shaping of flaps.Each of the equipments in the groups was dismantled instantly after one day,two days,three days,four days and six days respectively after the operation.Afterwards the color and swelling degree of the flaps were observed,a sample with the size of 0.3 cm×0.5 cm was cut and the flap survival area was measured altogether on the seventh day.The expressions of flap histology and CD34 were observed mainly through HE staining and immunohistochemistry.The statistical data were treated to figure out the flap survival rate and determine whether statistical differences lie in the neovascularized microvessel density（MVD） in the flaps.Results ①the swelling,edema and congestion of side flaps under experiment were obviously mitigated compared with those under control,and VSD promoted the survival of flap,and the survival area was the largest on the third day.②VSD encouraged the increase of MVD in the flap and further contribu

关 键 词：负压封闭引流技术 任意皮瓣 微循环灌注压 

分 类 号：R62[医药卫生—整形外科]