摘要
目的 探讨以腹壁上动脉为蒂的大白鼠下腹壁TRAM皮瓣的血运特点。方法 在大白鼠下腹壁设计并建立动脉供血不足、静脉回流部分受阻以及增加IV区静脉回流的 3种TRAM皮瓣实验模型。结果 ①以腹壁上动脉供血的大白鼠下腹壁TRAM皮瓣其成活面积可至双侧腋前线。②腹壁上动脉主干主要营养TRAM皮瓣的Ⅰ区和Ⅱ区。③静脉回流部分受阻可造成TRAM皮瓣Ⅲ区和Ⅳ区的坏死。④增加TRAM皮瓣第IV区尖端的皮静脉回流 ,可明显增加此皮瓣的成活面积。
Objective To evaluate the circulatory characteristics of the TRAM flap because the vascular supply to lateral portion of the conventional TRAM (zone 4) occasionally may become compromised resulting in necrosis of fat tissue or requiring segmental excision of the poor perfused tissue.Methods In this study,we designed a rat pedicled TRAM flap model with either inadequate arterial or venous circulation. The skin paddle was photographed and the survival areas were measured on the tenth postoperatiive day. Results The results showed that the group with poor arterial inflow of the flap,which resulted from ligation of the superior deep epigastric artery,exhibited skin necrosis in zone 1 and 2. Venous stasis due to selective ligation of the venous pedicle resulted in necroses of a major area in the lateral part of the flap,especially in zone 4. However,venous stasis may be alleviated by an additional cutaneous venous return system. Conclusions Our results demonstrated that conventional rat TRAM flap with poor arterial inflow differs from that with venous stasis in terms of manifestations and extent of inadequate circulation. Necrosis of the lateral protion of human TRAM flaps may therefore be attributed to problems of venous stasis. Such problems might then be ameliorated by creating an additional cutaneous venous return system.
出处
《中华整形外科杂志》
CAS
CSCD
北大核心
2000年第2期90-93,共4页
Chinese Journal of Plastic Surgery
