{"title":"Impact of Diameter of Perforator in Pedicle and Different Managements of Intermediate Non-Pedicle Perforator on Flap Survival in Rats.","authors":"Donghong Liu, Fang Fang, Yuehong Zhuang","doi":"10.1080/08941939.2022.2097345","DOIUrl":null,"url":null,"abstract":"<p><strong>Backgrounds: </strong>The quantified relationship between perforator diameter and flap length can be supported, and the impact of different strategies of managements of a non-pedicled perforator with two major subfascial divisions on flap survival has never been explored.</p><p><strong>Materials and methods: </strong>This study was divided into two parts. In Part I, 48 Sprague-Dawley rats underwent flap harvesting based on six perforators with a diameter gradient. Then, the flap length and perforator diameter were measured for establishment of an equation. In Part II, 32 rats underwent harvest of a transverse flap based on the right superficial epigastric perforator. In 16 rats the right intermediate iliolumbar perforator was severed in a distal-to-division approach, whereas, in the other 16 rats, it was severed with in a proximal-to-division approach. Necrosis rates and blood perfusion were also compared.</p><p><strong>Results: </strong>The equation y = 13.02 × x + 2.29 could be established between the perforator diameter in the pedicle (x) and the flap length (y) that could be supported with R<sup>2</sup>=0.8963 and P < 0.001.The transverse flap with a distal-to-division management of the intermediate iliolumbar perforasome was weaker in perfusion and had a necrosis rate of 49±4%, whereas the flap with a proximal-to division management had a significantly stronger perfusion and a lower necrosis rate of 21±2% (P<0.001).</p><p><strong>Conclusions: </strong>The safe flap length that can be estimated based on a perforator with a known diameter can be calculated using y=13.02× x +2.29. A short segment of the stem of an intermediate perforator with two major subfascial branches should be preserved to augment flap survival.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"35 9","pages":"1686-1693"},"PeriodicalIF":2.1000,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Investigative Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/08941939.2022.2097345","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2022/7/19 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0
Abstract
Backgrounds: The quantified relationship between perforator diameter and flap length can be supported, and the impact of different strategies of managements of a non-pedicled perforator with two major subfascial divisions on flap survival has never been explored.
Materials and methods: This study was divided into two parts. In Part I, 48 Sprague-Dawley rats underwent flap harvesting based on six perforators with a diameter gradient. Then, the flap length and perforator diameter were measured for establishment of an equation. In Part II, 32 rats underwent harvest of a transverse flap based on the right superficial epigastric perforator. In 16 rats the right intermediate iliolumbar perforator was severed in a distal-to-division approach, whereas, in the other 16 rats, it was severed with in a proximal-to-division approach. Necrosis rates and blood perfusion were also compared.
Results: The equation y = 13.02 × x + 2.29 could be established between the perforator diameter in the pedicle (x) and the flap length (y) that could be supported with R2=0.8963 and P < 0.001.The transverse flap with a distal-to-division management of the intermediate iliolumbar perforasome was weaker in perfusion and had a necrosis rate of 49±4%, whereas the flap with a proximal-to division management had a significantly stronger perfusion and a lower necrosis rate of 21±2% (P<0.001).
Conclusions: The safe flap length that can be estimated based on a perforator with a known diameter can be calculated using y=13.02× x +2.29. A short segment of the stem of an intermediate perforator with two major subfascial branches should be preserved to augment flap survival.
背景:穿支直径与皮瓣长度之间的量化关系可以得到支持,但对于具有两个主要筋膜下分隔的无蒂穿支,不同的处理策略对皮瓣存活的影响从未被探讨过。材料与方法:本研究分为两部分。在第一部分中,48只Sprague-Dawley大鼠进行了基于六个直径梯度穿支的皮瓣收获。然后,测量皮瓣长度和穿孔直径,建立方程。在第二部分中,32只大鼠接受了基于右侧腹壁浅穿支的横向皮瓣。在16只大鼠中,右中间髂腰穿支在远端至分裂入路中被切断,而在另外16只大鼠中,它在近端至分裂入路中被切断。并比较坏死率和血流灌注。结果:经椎弓根穿支直径(x)与皮瓣可支撑长度(y)之间建立方程y = 13.02 × x + 2.29, R2=0.8963, P < 0.001。髂中段穿支远端分束管理的横瓣灌注较弱,坏死率为49±4%,而近端分束管理的皮瓣灌注较强,坏死率较低,为21±2% (p)结论:根据已知直径的穿支估计的安全皮瓣长度可以用y=13.02× x +2.29计算。中间穿支茎的短段与两个主要的筋膜下分支应保留,以增加皮瓣的生存。
期刊介绍:
Journal of Investigative Surgery publishes peer-reviewed scientific articles for the advancement of surgery, to the ultimate benefit of patient care and rehabilitation. It is the only journal that encompasses the individual and collaborative efforts of scientists in human and veterinary medicine, dentistry, basic and applied sciences, engineering, and law and ethics. The journal is dedicated to the publication of outstanding articles of interest to the surgical research community.