Dataset Information

Effects of Venous Superdrainage and Arterial Supercharging on Dorsal Perforator Flap in a Rat Model.

ABSTRACT:

Objective

To comparatively assess the effects of venous superdrainage and arterial supercharging on dorsal perforator flap survival.

Materials and methods

Sixty male Sprague-Dawley rats (450-550g) were randomly divided into three groups (n = 20), including control group (Control) and experimental groups A (venous superdrainage, Exp. A) and B (arterial supercharging, Exp. B). At postoperative day 7, survival areas of the flaps were evaluated and all animals underwent angiography. Laser Doppler was used to evaluate flap perfusion from 0h to 7days after surgery. Histology with hematoxylin and eosin staining was used to count microvessels. Tissue of "Choke vessels"was excised for quantification of hypoxia inducible factor-1? (HIF-1?) and vascular endothelial growth factor (VEGF) by western blot assay at 6h and 7days after surgery.

Results

In the Exp. A group, almost all flaps survived (98.2±1.6%); in the Exp. B and control group, survival areas accounted for 78.8±8.5% and 60.3±7.8%, respectively (P <0.001). In addition, Exp. A animals showed improved anastomosis of choke vessels 2 compared with the Exp. B and Control groups. Furthermore, flap blood flow and partial pressure of oxygen in the Exp. A group were significantly higher compared with values obtained for the Exp. B and Control groups, from 6 hours to 7 days after surgery. More microvessels were found in the Exp. A group (11.65±1.33) than in Exp. B (9.25±0.34) and control (7.25±0.91) animals on POD 7. The relative expression level of HIF-1? and VEGF were significant at 6h and 7days after surgery.

Conclusions

Venous superdrainage in rat dorsal perforator flap is more effective than arterial supercharging in promoting flap survival, and could effectively alter hemodynamics in the microcirculation and stimulate blood vessel formation.

SUBMITTER: Zheng J

PROVIDER: S-EPMC4981354 | biostudies-literature | 2016

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Effects of Venous Superdrainage and Arterial Supercharging on Dorsal Perforator Flap in a Rat Model.

Zheng Jun J Xi Shanshan S Ding Maochao M Li Hong H Xu Wei W Tang Maolin M Chen Shixin S

PloS one 20160811 8

<h4>Objective</h4>To comparatively assess the effects of venous superdrainage and arterial supercharging on dorsal perforator flap survival.<h4>Materials and methods</h4>Sixty male Sprague-Dawley rats (450-550g) were randomly divided into three groups (n = 20), including control group (Control) and experimental groups A (venous superdrainage, Exp. A) and B (arterial supercharging, Exp. B). At postoperative day 7, survival areas of the flaps were evaluated and all animals underwent angiography. L ...[more]

PMID: 27513520

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Project description:BackgroundPerforator flaps account for a fraction of reconstructive procedures despite their growing popularity. Specific microsurgical skills are required for successful harvesting of perforator flaps, which are difficult to attain through direct operating room training. Cadaver and small animal dissection cannot simulate human perforator dissection, lacking either bleeding and vessel feedback or providing too small calibers. Thus, we have developed and refined over the last ten years five perforator flaps models in living pig, described their harvesting technique and provided evidence for their effectiveness as perforator flap training models.MethodCT angiography data from ten living pigs was used for detailed examination of the integument's vascular anatomy. Microsurgical techniques were used to standardize and harvest the perforator flaps in acute models. The same operator-assistant team, with no prior perforator flap harvesting experience, raised all flaps in a sequential manner, one animal per day, during a 7 weeks timespan. Porcine flaps were compared to human counterparts in terms of vessel caliber, dissection times. Immediate flap survival was measured as duration of perforator pulsation after completion of flap harvesting, measured every 10 minutes for up to two hours.ResultsFive perforator flaps were standardized, based on the deep cranial epigastric, thoracodorsal, lateral intercostal, cranial gluteal and dorsal cervical arteries and the operative technique was described in detail. Mean pig perforator size was 1.24±0.36 mm and mean pedicle diameter was 2.78±0.8 mm, which matched closely the human calibers for each flap. Total harvesting time increased 22.4% between the first two experiments due to a more cautious approach following the lack of perforator pulsation in all flaps in the first experimental animal. A total decrease of 44.4% harvesting time between second and last experiment was observed, as expected with all repetitive surgical procedures. Post-operative perforator pulsation time revealed a steep learning curve, with no or short-term pulsatile perforators in the first five pigs, followed by a 275% increase in total perforator pulsation time between 5th and 6th experimental animal. Based on these findings we provide a description of the most common mistakes, their consequences and gestures which can be trained using the pig perforator flaps, in order to overcome these mistakes.ConclusionThese five pig perforator flap models provide a fast and efficient learning tool to develop perforator flap harvesting skills safely. Surgical training using these five experimental models offers a similar hands-on perforator flap dissection experience as with human tissue, based on the similar sized calibers of both perforators and pedicles with their human counterparts.

Dataset Information

Effects of Venous Superdrainage and Arterial Supercharging on Dorsal Perforator Flap in a Rat Model.

Objective

Materials and methods

Results

Conclusions

Publications

Effects of Venous Superdrainage and Arterial Supercharging on Dorsal Perforator Flap in a Rat Model.

Similar Datasets

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