title: Prefabricated Flaps: Identification of Microcirculation Structure and Supercharging Technique Improving Survival Area.
abstract: BackgroundMicrocirculation is an important factor frequently overlooked when studying the survival of prefabricated flaps. In the current study, we use different prefabrication techniques for characterizing microcirculation within the flap, with the goal of finding an effective way to improve its survival area.MethodsAn abdominal prefabricated flap rodent model was created using a two-stage operation. All rats were randomly divided into six groups (n= 10/group): group A, prefabricated femoral vessels; group B, prefabricated femoral artery with a connected superficial inferior epigastric vein (SIEV); group C, connected superficial inferior epigastric artery (SIEA) with a prefabricated femoral vein; group D was similar to group A along with a prefabricated SIEA, and group E was similar to group A along with a prefabricated SIEV; and group F acted as a control group and consisted of an axial flap nourished by superficial inferior epigastric vessels. Flaps were assessed for survival area, blood perfusion area, and capillary density using macroscopic analysis, near-infrared fluorescence imaging (NIFI), and histology.ResultsThe survival area was not significantly different when comparing groups B to C, and D to E. The survival area of groups D and E was larger than that of groups B and C. Groups B through E had a smaller survival area in comparison to group F and a larger survival area than group A. NIFI were consistent with the macroscopic outcomes. The capillary density was not significantly different between groups A to C and groups D to F.ConclusionBoth arterial and venous supercharging could potentially improve the survival area of prefabricated flaps.
authors.affiliation: Department of Plastic Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Heng
authors.initials: H
authors.lastname: Xu
authors.affiliation: Department of Plastic Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Shaoqing
authors.initials: S
authors.lastname: Feng
authors.affiliation: Department of Anesthesiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Yimeng
authors.initials: Y
authors.lastname: Xia
authors.affiliation: Department of Orthopaedic Surgery, Sheba Medical Center, Tel HaShomer, Israel.
authors.forename: Zvi
authors.initials: Z
authors.lastname: Steinberger
authors.affiliation: Department of Plastic Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Wenjing
authors.initials: W
authors.lastname: Xi
authors.affiliation: Department of Anesthesiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Hongwei
authors.initials: H
authors.lastname: Fang
authors.affiliation: Department of Orthopaedic Surgery, Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Zhiwei
authors.initials: Z
authors.lastname: Li
authors.affiliation: Department of Plastic Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Yixin
authors.initials: Y
authors.lastname: Xie
authors.affiliation: Department of Plastic Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Yixin
authors.initials: Y
authors.lastname: Zhang
mesh_terms: D000714:Anastomosis, Surgical / Q000379:methods*; D000818:Animals; D004195:Disease Models, Animal; D005263:Femoral Artery; D006085:Graft Survival; D008297:Male; D008833:Microcirculation; D051381:Rats; D017207:Rats, Sprague-Dawley; D019651:Plastic Surgery Procedures / Q000379:methods*; D017568:Rectus Abdominis / Q000098:blood supply* / Q000637:transplantation; D013524:Surgical Flaps / Q000098:blood supply*