Vascularized lymph node flaps can survive on venous blood without an arterial inflow:an experimental model describing the dynamics of venous flow using indocyanine green angiography(With video)  

作　　者：Ke Li Fabio Nicoli Chunxiao Cui Yan Wo Ning Fei Liu Shaoqing Feng Wenjing Xi Peiru Min Yixin Zhang 

机构地区：[1]Department of Plastic and Reconstructive Surgery,Shanghai Ninth People’s Hospital,Shanghai JiaoTong University School of Medicine,Shanghai 200000,China [2]Translational and Clinical Research Institute,Newcastle University,Newcastle upon Tyne NE11AD,UK [3]Department of Plastic and Reconstructive Surgery,University of Rome“Tor Vergata”999016,Italy [4]Department of Plastic and Reconstructive Surgery,Northumbria NHS Trust,Newcastle upon Tyne NE11AD,UK [5]Department of Facial Plastic and Reconstructive Surgery,ENT Institute,Eye and ENT Hospital,Fudan University,Shanghai 200000,China [6]Department of Anatomy and Physiology,School of Medicine,Shanghai Jiao Tong University,Shanghai 200000,P.R.China

出　　处：《Burns & Trauma》2023年第1期470-478,共9页烧伤与创伤（英文）

基　　金：The national natural science foundation of China(Grant Number:81772098);Clinical Multi-Disciplinary Team Research Program of 9th People’s Hospital,Shanghai Jiao Tong University School of Medicine(Grant Number:2017-1-007);Clinical Research Program of 9th People’s Hospital,Shanghai Jiao Tong University School of Medicine(Grant Number:JYLJ027);Shanghai Municipal Education Commission Gaofeng Clinical Medicine Grant Support(Grant Number:20152227);The national natural science foundation of China(Grant Number:82000456);Scientific research foundation of Shanghai Municipal Commission of Health and Family Planning(Grant Number:20154Y0023).

摘　　要：Background:Several surgeons have described studies of free-tissue transfers using veins instead of arteries.These innovative microsurgical techniques can offer several advantages,such as an easier dissection during flap harvesting,and represent an alternative during an accidental surgical mistake or development of new surgical procedures.The purpose of this study was to describe and explore different constructs of vascularized lymph node transfer(VLNT)only based on venous blood flow in a mouse model,evaluate their blood flow microcirculation through indocyanine green(ICG)angiography and investigate the lymphatic drainage function and the lymph nodes’structures.Methods:Five types of venous lymph node flaps(LNF)were created and investigated:Types IA,IB,IC,IIA and IIB were developed by ICG intraoperatively(with videos in the article).Seven weeks later,by applying methylene blue,the recanalization of the lymphatic vessels between the LNF and the recipient site was detected.Lymph nodes were collected at the same time and their structures were analyzed by hematoxylin and eosin staining analysis.Results:All of the venous LNFs developed except Type IC.Seven weeks later,methylene blue flowed into Types IA,IB,IIA and IIB from recipient sites.When comparing with arteriovenous lymph node,the medullary sinus was diffusely distributed in venous lymph nodes.The proportion of cells was significantly reduced(p<0.05).The artery diameters were significantly smaller(p<0.05).The veins diameters and lymphatic vessels output in Types IA,IB,IIA and IIB were more dilated(p<0.05).Conclusions:This research demonstrated that Type IA,IB,IIA and IIB venous LNFs can retrogradely receive venous blood supply;they can survive,produce a lymphatic recanalization and integrate with the surrounding tissue,despite lymph node structural changes.Our results will improve the understanding of the survival mechanism of venous LNFs and will help researchers to design new studies or lymphatic models and eventually find an alternative procedure for the surg

关 键 词：Vein circulation VENOUS Lymph node FLAP Vascularized lymph node flap LYMPHEDEMA Indocyanine green 

分 类 号：R543[医药卫生—心血管疾病]