Effect of preserved pedicle fascia on the survival of rat posterior intercostal artery perforator pedicle flap
10.3760/cma.j.cn114453-20220523-00157
- VernacularTitle:保留蒂部筋膜对大鼠肋间后动脉穿支蒂皮瓣成活的影响
- Author:
Xue WANG
1
;
Yanfei DONG
;
Xinyi LI
;
Xiaojing LI
Author Information
1. 安徽医科大学第一附属医院整形外科，合肥 230022
- Keywords:
Surgical flaps;
Perforator pedicle flap;
Fascia;
Hypoxia-inducible factor-1α;
cytoglobin;
Sprague-Dawley rat
- From:
Chinese Journal of Plastic Surgery
2023;39(1):81-89
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effect of preserved pedicle fascia on the survival of rat posterior intercostal artery perforator pedicle flap.Methods:Fifty SD rats (male and female) were randomly divided into two groups, A and B, with 25 rats in each group. The flap pedicled with the perforating branch of the posterior intercostal artery was designed and cut from the right back of each SD rat, with the size of 10.0 cm×2.5 cm. The perforator branch and the surrounding fascia tissue of 2.5 cm×1.0 cm were retained in group A, while only the perforator branch was retained in group B, the fascia tissue around the perforating branch was removed as much as possible. Finally, the two groups of flaps were sutured in situ. Flap survival of the two groups was observed and the survival rates were calculated. The two groups of flaps were cut and stained with HE, and the angiogenesis of the specimens was observed under a light microscope. Image-Pro Plus 6.0 software was used to calculate the blood vessel density in the sections stained with HE on the 7th day after surgery, vessel diameter and vessel wall thickness were measured and calculated. The expressions of hypoxic-inducible factor-1α (HIF-1α) and cytoglobin (CYGB) in the two groups of flaps were detected by immunohistochemistry. The relative expressions of HIF-1α and CYGB in the two groups were detected by Western blotting, and the differences between the two groups were compared. The measurement data were expressed as Mean±SD. Bilateral t-test was used to compare the data between the two groups, and P<0.05 indicated statistically significant difference. Results:The flaps in group A survived well, while the flaps in group B had distal ischemic necrosis. The survival rate of the flaps in group A (96.19%±0.65%) was higher than that in group B (88.97%±3.24%) at 7 days after operation, and the difference was statistically significant ( P<0.01). HE staining showed neovascularization in both groups. The new blood vessels in group A were higher than those in group B. Blood vessel density, blood vessel diameter and blood vessel wall thickness in group A were (7.77±0.92) vessels/mm 2, (65.23±14.62) μm and (10.49±1.99) μm, respectively, which were higher than those in group B [(5.82±0.85) vessels/mm 2, (40.61±7.78) μm and (6.27±2.63) μm]. The differences were statistically significant( P<0.05). Immunohistochemistry showed that HIF-1α expression in group A was higher than that in group B on day 1 after surgery, and gradually tended to be stable. CYGB expression in group A and Group B peaked on the 7th day after surgery. The results of Western blotting showed that the expression level of HIF-1α in group A was higher than that in group B on the first and third day after surgery, with statistical significance ( P<0.01). HIF-1α in group A reached its peak on the fifth day after surgery, then gradually decreased and tended to be stable. HIF-1α expression in group B was higher than that in group A on the 5th, 7th and 9th day after surgery ( P<0.01), and showed a slow decreasing trend until the 9th day. The expression level of CYGB in group A was higher than that in group B on the third, fifth and ninth day after surgery ( P<0.01), which had statistical significance. The expression of CYGB in group A and Group B reached a peak on day 7 after surgery. Conclusion:The survival rate of the rat posterior intercostal artery perforator flap can be improved by keeping part of fascia in the pedicle, which may be caused by the stable expression of HIF-1α and the upregulated expression of CYGB.
