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The experimental study of shunt-decompression arterialized vein flap.


ABSTRACT:

Background

Arterialized vein flap is a kind of unphysiological flap. Unphysiological reconstruction of blood circulation leads to higher load than that supported by physiological flap and is the culprit of flap swelling, blood stasis, skin blistering, and necrosis after flap grafting. To resolve the multiple disadvantages of traditional flap grafting, by introducing the principles of fluid mechanics, shunt-decompression surgery is prepared to decline the circulation preload and improve the prognosis of arterialized vein flap grafting.

Methods

By introducing the principles of fluid mechanics, we established the model of shunt-decompression arterialized vein flap, which satisfied the common properties of general fluid that the interface pressure between object and fluid is reduced when the velocity of fluid is increased and vice versa-the effect of Bernoulli. Under this rule, we anastomose the arterialized vein to the branch of main artery of recipient region or make end-to-side anastomosis, which can maintain the blood flow of main artery, decrease the perfusion of flap, and preserve the decompressive effect of main artery to branches. From March, 2016 to September, 2016, we performed animal experiments on ten male bama mini pigs with average weight of 28?±?2.35 kg. Superior epigastric artery of pig was used for feeding artery to arterialize the superficial epigastric veins. The total area of flap is 8 cm?×?6 cm. End-to-side anastomosis and end-to-end anastomosis were established in experimental group and control group, respectively. Doppler speckle perfusion imaging apparatus was used to monitor the alterations of flap perfusion, blood flow of flap, tissue swelling and survival of flaps.

Results

The average flap perfusion (PU) at 1 week after surgery is 83.62?±?3.14 in experimental group and 98.14?±?6.54 in control group, respectively (P?ConclusionBased on the physiological features of arterialized vein flap and its problems in clinical application, we improved the anastomosis strategy of flap grafting and obtained excellent experimental outcomes, which provides an insight for the clinical application of arterialized vein flaps.

SUBMITTER: Li Z 

PROVIDER: S-EPMC6161395 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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The experimental study of shunt-decompression arterialized vein flap.

Li Zheng Z   Zhang Zhen-Wei ZW   Yu Shao-Xiao SX   Zhuang Jia-Chuan JC   Ke Yu-Hai YH   Xiong Yi Y   Lin Hui-Xin HX   Chen Wen-Feng WF  

Cancer cell international 20180927


<h4>Background</h4>Arterialized vein flap is a kind of unphysiological flap. Unphysiological reconstruction of blood circulation leads to higher load than that supported by physiological flap and is the culprit of flap swelling, blood stasis, skin blistering, and necrosis after flap grafting. To resolve the multiple disadvantages of traditional flap grafting, by introducing the principles of fluid mechanics, shunt-decompression surgery is prepared to decline the circulation preload and improve t  ...[more]

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