It has been generally believed that the continuous flow of blood characterised by arterial inflow and venous outflow is essential for the survival of flaps. Since Baek et al.(1985) demonstrated the survival of a flap based on only a single vein without arterial inflow, there have been a lot of reports of successful skin flaps that depend on only venous blood flow. The location of pedicle is one of the important factors on the survival of flaps, but there have not been an effective study on the survival rates of venous island flaps according to their location of pedicles. In this study, we compared the survival rates of proximally based venous island flaps with those of distally based ones and attempted to decrease the difference, if any, in the survival rates between them. Distally or proximally based 4x3 cmvenous island flap, whose pedicle was a marginal branch of central vein, was elevated from the auricular cartilage of New Zealand white rabbit. IN the half of 20 rabbits, superoxide dismutase (SOD, 20,000 U/kg) was injected intravenously 30 minutes and 60 minutes after the flap elevation. On the 7th postoperative day, survival areas of the flaps were measured by image analysis system and the vascular network with the flaps were examined by micro fil cast. 40 flaps were divided as follows: proximally based venous flaps, distally based venous flaps, SOD treated proximally based venous flaps, SOD ttreated distally based venous flaps. The results were as follow: 1. The survival rate(79.39+/-9.24%) of the proximally based venous flaps were significantly higher than those(60.79+/-14.10%) of the distally based ones (p< 0.01). 2. SOD improved survival of the flap significantly (p< 0.05), and there was no statistical difference in the survival rates between proximally based venous flaps and SOD treated distally based venous flaps (p = 0.1785). 3. Revascularization was actively developed in the proximally based venous flaps and those flaps treated with SOD, but was minimal in the distally based venous flaps. These results suggested that the vascular pedicle would rather be located proximally than distally in designing the venous island flaps and that SOD treatment may be effective for the enhancement of survival of venous island flaps, especially in distally based ones.
Ear Cartilage ; New Zealand ; Rabbits ; Skin ; Superoxide Dismutase* ; Superoxides* ; Surgical Flaps ; Survival Rate ; Veins

No abstract available.
Chickens* ; Plasminogen* ; Tendons*

No abstract available.

No abstract available.
Granuloma* ; Subphrenic Abscess*

Island flaps have been widely used for the management of soft tissue defects in reconstructive surgery. The necrosis of the flap has been a catastrophe in clinical fields. It is well known that revascularization to the flap after ligation of its pedicle comes from the recipient bed and flap margins. The authors investigated the effects of the ischemic recipient bed on island flap survival after the ligation of its pedicle in the rats. One hundred and thirty inferior epigastric island flaps were divided into three groups (Group I, Group II, and Group III) according to the degree (0%,20%, and 60%) of interruption of contact of flap with the recipient bed, respectively. In Group I,the vascular pedicles were ligated before and on the 0, 2nd, 3rd, 4th and 5th days after flap elevation, and in Group II & III, the vascular pedicles were ligated on the 2nd, 3rd, 4th and 5th days after flap elevation. Flap survival was assessed on the 3rd day after pedicle ligation. Microangiographic studies were also performed on the 3rd day after pedicle ligation to study revascularization within the flap and the change of blood vessels around the flap margins. The results were as follows: 1. Flap survival was increased significantly in the flaps with pedicle ligation on the 4th and 5th postoperative days compared to those at the 2nd and 3rd postoperative days. 2. From the 3rd postoperative day, flap survival was not influenced significantly by the degree of limited bed contact and the date of pedicle ligation. 3. In spite of limited bed contact, the flap will likely survive with abundant revascularization from the flap margins. In conclusion, the flaps with limited bed contact were revascularized significantly from the flap margin by the 3rd postoperative day.
Animals ; Blood Vessels ; Ligation ; Necrosis ; Rats ; Surgical Flaps

No abstract available.
Dislocations* ; Hip* ; Osteotomy*

No abstract available.
Breast Neoplasms* ; Breast* ; Humans ; Necrosis*

No abstract available.

No abstract available.
Animals ; Lymphocyte Subsets* ; Lymphocytes* ; Rats*

It remains a problem that successful revascularization and reperfusion after ischemia are associated with high systemic complication rates and severe local tissue injuries. With prolonged ischemia, there is damage to tissue from anoxia, but further injury may occur after reperfusion. The activation of leukocytes and endothelial cells during reperfusion causes neutrophil adhesion in capillaries, resulting in plugging and further ischemia, Alternativety, neutrophil adhesion to endothelium leads to the migration of neutrophil with local edema formation, hemorrhage and thrombosis. Some chemotactic and activating factors are needed to propel neutrophils to the site of local inflammation. The chief cytikines that induce a pro-adhesive state in endothelium are tumor necrosis factor-alpha(TNF-alpha), interleukin-1 beta(IL-1 beta) and endotoxin or lipopolysaccharide(LPS). Similarly, TNF-alpha,and to a lesser extent interleukin-8(IL-8), is the important stimulus that acts on neutrophils and other leukocytes to alter their adhesion. The purpose of this study was to evaluate the pathogenetic role of IL-8 after perfusion with CDl8 monoclonal antibody(CDl8 mAb), the blocking antibody of neutrophil adherence, on reperfusion injury in rat epigastric island skin flap. A 6 X 3 cm-sized island skin flap was made on the abdomen. The epigastric pedicle was occluded for six hours with ambient temperature. Fifteen minutes before reperfusion, the flap was perfused with saline and CDl8 mAb(1 mg/kg). For evaluation of IL-8 levels, tissue fluid and serum were obtained at 4, 8, 12 and 24 hours after reperfusion. IL-8 concentrations of the CDl8 mAb group in the tissue fluid were significantly decreased at 8, 12 and 24 hours compared to the control group(P > 0.01), but the difference between the two groups was not significant at 4 hours after reperfusion IL-8 concentrations of the CDl8 mAb group in the serum were significantly decreased over time compared to the control group(P > 0.05, p > 0.01). Form the above results, we concluded that blocking neutrophil adherence using CD18 mAb within the peak level of IL-8 at 4 hours after reperfusion may be a better method of reducing reperfusion injury to the island skin flap.
Abdomen ; Animals ; Anoxia ; Capillaries ; Edema ; Endothelial Cells ; Endothelium ; Hemorrhage ; Inflammation ; Interleukin-1 ; Interleukin-8* ; Ischemia ; Leukocytes ; Necrosis ; Neutrophils ; Perfusion ; Rats ; Reperfusion Injury* ; Reperfusion* ; Skin ; Thrombosis