[Effect of vacuum drainage on the blood circulation of expanded flap in ear reconstruction].
OBJECTIVE
To investigate the effect of vacuum drainage on blood circulation of expanded skin flap, so as to confirm suitable negative pressure for ear reconstruction.


METHODS
21 patients (Auricular Reconstructive Center of Plastic Surgery Hospital, PUMC) were randomly divided into A, B, C 3 groups to receive vacuum drainage of: -20, -40 and -60 kPa, respectively. The length and width of reconstructed ears,which represented the swelling degree, were measured instantly and 5, 10 days postoperatively. The changes were calculated and reflected venous drainage of flaps. The temperature of proximal (concha) and distal (helix) part of the expanded flaps, which represented the arterial blood supply of flaps, was detected by infrared thermography after operation.


RESULTS
Five days after operation [(1.48 +/- 0.47) mm, (0.36 +/- 0.06) mm] and immediately [(1.67 +/- 0.69) mm, (0.40 +/- 0.16) mm)] , the changes of the length and width of reconstructed ear in group B was significantly low, while there was no statistically difference between group A and C (P > 0.05). The data between 10 days and 5 days after operation showed the same result. Along with the increase of the negative pressure, the swelling degree of reconstructed ears decreased firstly and then increased reversely ( P < 0.01 ). The flap temperature of reconstructed ears increased (P < 0.01), especially in proximal (concha) part (P < 0.01) , when the negative pressure increased (0 to -60 kPa).


CONCLUSIONS
Vacuum drainage has effect on both the venous drainage and blood supply. Negative pressure of -40 kPa can improve both the blood supply and venous drainage. It should be as reference for clinical application.
Plastic Surgery Hospital, Peking Union Medical College & Chinese Academy of Medical Science, Beijing 100144, China.
Bo
B
Pan
Hai-Yue
HY
Jiang
Yan-Yong
YY
Zhao
Lin
L
Lin
Gao-Feng
GF
Zhao
Rongwei
R
Wu
D002648:Child; D054644:Ear Auricle / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D054843:Negative-Pressure Wound Therapy / Q000379:methods*; D019651:Plastic Surgery Procedures / Q000379:methods; D012272:Ribs / Q000637:transplantation; D016038:Skin Transplantation / Q000379:methods; D013524:Surgical Flaps / Q000098:blood supply*; D014182:Transplantation, Autologous