1.Changes of accompanying femoral artery and vein blood gas analysis in patients with burn sepsis
Chejiang WANG ; Hongxia LIU ; Yimin WANG ; Lingmin MENG ; Li ZHANG ; Qingfu ZHANG
Tianjin Medical Journal 2015;(1):72-73,74
Objective To discuss changes of accompanying femoral artery and vein blood gas in patients with burn sep?sis. Methods The retrospective data of twenty-two patients with burn sepsis and forty-three non-sepsis patients (control) was analyzed, and changes of accompanying femoral artery and vein blood gas were compared between two groups. Results Results of femoral artery gas analysis showed that the HCO3-concentration was lower in sepsis group than that of control group. Results of femoral vein blood gas showed that the partial pressure of carbon dioxide [p(CO2)] was higher in sepsis group than that of control group;the oxygen saturation (SvO2) and HCO3-concentration was lower in sepsis group than that of control group (P<0.01). The differences between oxygen partial pressure p(O2), p(CO2), HCO3-concentration, oxygen satura?tion of femoral artery and vein blood gas were significantly higher in sepsis group than those of control group ( P<0.01). Conclusion Results of femoral vein blood gas analysis change obviously in patients with burn sepsis . The detection of accompanying femoral artery and vein blood gas is beneficial to diagnosis of burn sepsis.
2.Random flap experimental study of dynamic changes of blood flow
Hongbo SHAO ; Yueming YAO ; Qingfu ZHANG ; Jianke FENG ; Yongqiang BAI ; Chejiang WANG
Clinical Medicine of China 2009;25(12):1236-1238
Objective To know the establishment of the flap pedicle blood supply and the right moment of the cutting off of pedicle by means of laser Doppler blood perfusion imaging instrument on the random flap blood flow changes.Methods 20 adult healthy rabbits were divided in to four groups and each 5 have unilateral flaps.1,3,5,7,9,12,14,18 days after operation,the pedicle blood perfusion values (PU) measurement of the distal pedicle on the flap and midpoint of both ends of the pedicle were performed,and PU values were analyzed.Results Pedicle of the PU values at the different time points changed little (P>0.05).The PU value in the distal flap reached the minimum 1 day after operation and then increased gradually [3 d (1.24±0.07),5 d (1.57±0.15),7 d (1.79±0.08),9 d(1.89±0.13),12 d(2.01±0.16),14 d(2.18±0.09) and 18 d(2.40±0.18),P<0.05].When distal PU values/pedicle PU value≥1.2,the flap survival rate reached 99%.Conclusions The establishment of random skin flap blood circulation,as well as the ratio of PU values of distal to the pedicle flap pedicle can be used as the timing of an important indicators.
3.Random flap microcirculation and pedicle division timing: Can laser Doppler imaging evaluate them?
Yueming YAO ; Hongbo SHAO ; Qingfu ZHANG ; Jianke FENG ; Yongqiang BAI ; Chejiang WANG
Chinese Journal of Tissue Engineering Research 2010;14(18):3355-3358
BACKGROUND: Random flap as a primary means of wound healing, is widely used at present, its blood circulation to establish the situation is also researched a lot, but not yet the system of random skin flap perfusion were observed and measured. In addition, the timing of pedicle division of a pedicle flap random is also a hot topic, but not yet a mature clinical testing method has been discovered to determine the best timing.OBJECTIVE: By means of laser Doppler blood perfusion imaging, this study was designed to dynamically observe random flap microcirculation, to understand the changes on random flap blood flow, and to determine the best timing of pedicle division. METHODS: A total of 18 cases were divided into traditional pedicle division group and early pedicle division group. Pedicle flap blood perfusion values were statistically measured immediately after surgery, at 3, 7,11,15, and 19 days after surgery, before division, immediately after division, and at 24 hours after pedicle division, 8-9 phases in total.RESULTS AND CONCLUSION: Distal blood perfusion value was increased with the time prolongation in both groups; while, the blood perfusion in various time phases was significantly different from that after surgery (P < 0.05); but, the blood perfusion was decreased immediately after surgery, which was still significantly compared with traditional pedicle division group (P< 0.05). There was no significant different in blood perfusion between early pedicle division and immediate after surgery of pedicle division (P > 0.05), but there was significant difference between 24 hours after pedicle division and immediate after surgery of pedicle division (P< 0.05). Blood perfusion values were less changed in both groups (P> 0.05). The ratio of both groups peaked before pedicle division and then gradually decreased after pedicle division. The best timing of pedicle division was the ratio of 1.2.
4.Pentoxifylline for random flap survival: Evaluation using laser-Doppler blood reperfusion image
Hongbo SHAO ; Yueming YAO ; Qingfu ZHANG ; Jianke FENG ; Yongqiang BAI ; Chejiang WANG
Chinese Journal of Tissue Engineering Research 2010;14(5):838-842
BACKGROUND: Pentoxifylline (PTX), as an effective drug to improve blood rheology, has been used as a vasodilator for the treatment of vascular diseases and peripheral vascular disease science 1960s. But the role of PTX on skin blood flow to improve flap survival remains still unclear. OBJECTIVE: Through the clinical application of PTX therapy, the dynamic observation of random flap to understand that the PTX can promote flap survival and improve blood circulation of flap. METHODS: A total of 39 patients (27 males and 12 females aging 7-54 years) with skin tissue defect undergoing random flap repairing were selected from Department of Burn and Plastic Surgery, First Hospital of Hebei Medical University. The 39 cases were randomly divided into control group and drug group. Patients in the drug group were given intravenous injection of 250 mL PTX at day 2 after random flap operation, once a day, until 14 days after flap repairing surgery. On the first day after flap pedicle surgery, 250 mL PTX sodium chloride injection was intravenously given, once a day, until 7 days after flap pedicle surgery. The control group was not given PTX treatment. The value of blood perfusion (PU) was measured using laser-Doppler blood reperfusion image after flap transplantation, before and after pedicle division. RESULTS AND CONCLUSION: All 39 patients were completely cured and discharged, with no interruption experiments. Before pedicle division, PU value at distal flap in both drug and control groups were increased obviously, and the PU value in the drug group was significantly higher than control group (P < 0.05); after pedicle division, the PU value in the two groups were decreased, and there was no significant difference between the two groups (P > 0.05). Prior to pedicle division, the PU value of pedicle was gradually decreased and then increased in the drug group, and that in the control group was gradually increased. On the seventh day, the PU value of pedicle was stable in the drug group, and there was no significant difference between the two groups (P> 0.05); after pedicle division immediately, the PU values of pedicle were decreased in the two groups, and then the increase in the drug group was remarkable compared to control group (P < 0.05). Two sets of random flaps all survived, and skin defects were successfully repaired after pedicle division. PTX can markedly increase blood perfusion after random flap transplantation, promote flap survival and pedicle division in an early stage, and effectively shorten the healing time.