Effect of distal veins on the survival of dorsal four-territory perforator flaps in rats
10.3760/cma.j.cn114453-20230411-00078
- VernacularTitle:远端静脉对大鼠背部四血管体跨区穿支皮瓣成活的影响
- Author:
Qiushi YI
1
;
Zhiheng CAI
;
Lihong YANG
;
Xinyi ZENG
;
Maolin TANG
;
Shanshan XI
Author Information
1. 长江大学医学部人体解剖学教研室,荆州 434023
- Keywords:
Surgical flaps;
Distal vein;
Angiosome;
Multi-territory perforator flap;
Arterial blood supply
- From:
Chinese Journal of Plastic Surgery
2023;39(9):966-973
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the effect of distal veins on the survival of a dorsal four-territory perforator flap in rats.Methods:A total of 32 SD rats were randomly divided into the control group and the experimental group, with 16 rats in each group. The multi-territory perforator flap including the bilateral iliolumbar and bilateral posterior intercostal angiosomes was cut from the back of each rat, with the size of 6 cm×7 cm. The right iliolumbar artery and vein were preserved in the control group, while the right iliolumbar artery and the right posterior intercostal vein were preserved in the experimental group. In both groups, incisions were made between the right iliolumbar angiosome and the right posterior intercostal angiosome. Finally, the flap was sutured back to their orthotopic site. At 6 hours and 1, 3, 5, 7 days after surgery, the blood perfusion at the bilateral iliolumbar and the left posterior intercostal vascular territories were measured. On the seventh day after surgery, the percentage of the survived area of the flaps were evaluated, arteriography was performed to observe the dilation of arteries within the flap, the intraluminal diameter of the choke artery in the choke 2 area was measured using hematoxylin and eosin staining, and the relative expression of endothelial nitric oxide synthase (eNOS) was detected by Western blotting. SPSS 28.0 was used for statistical analysis, and measurement data were presented as Mean±SD. Independent sample t-test was used to compare data across two groups. P<0.05 was considered statistically significant. Results:(1) At 6 hours and 1, 3, 5, 7 days after surgery, the experimental group displayed higher blood perfusion than the control group at the bilateral iliolumbar and the left posterior intercostal vascular territories (all P<0.01). (2) On the 7th day after surgery, the artery dilation of the experimental group was more obvious than that of the control group; the percentage of the survived flap area in the experimental group was higher than that in the control group [(87.6±3.2)% vs. (65.3±3.0)%, P<0.01]; the intraluminal diameter of the choke artery was greater in the experimental group than that in the control group[(49.3±3.1) μm vs. (35.1±2.3) μm, P<0.01]; and the relative expression of eNOS in the experimental group was higher than that in the control group (0.87±0.07 vs. 0.50±0.05, P<0.01). Conclusion:The distal vein (right posterior intercostal vein) of dorsal four-territory perforator flap of SD rats directly guided the pedicle artery blood supply to promote the expression of eNOS, dilated the arteries in each zone of the flap, increased the blood supply to the distal artery of the flap, and ultimately enhanced the flap survival area.