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Perfusion and Oxygenation of Random Advancement Skin Flaps Depend More on the Length and Thickness of the Flap Than on the Width to Length Ratio

机译:随机性皮瓣的灌注和充氧更多地取决于皮瓣的长度和厚度而不是长宽比

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>Objective: The aim was to investigate the relationship between the dimensions (length, width, and thickness) of random advancement skin flaps and retained tissue perfusion and oxygenation. >Methods: Flaps were raised on the flanks of pigs. The flaps were either 0.5 or 1.0 cm wide, thin (dissected halfway through the subcutaneous tissue) or thick (dissected down to the muscle fascia). Tissue perfusion was measured by laser Doppler velocimetry, and tissue oxygenation (pO2) was measured using a Licox system, every 0.5 cm along the flaps’ length. Tissue temperature was visualized by high-resolution infrared camera. >Results: Perfusion and oxygenation decreased gradually from the base to the tip of the flap, reaching approximately 40% of presurgical values (2.0 cm) and approximately 20% (2.5 cm) from the base of the flap. There was virtually no blood flow, nor oxygen tension, 3.0 cm from the base of the flap. The width to length ratio of the flap did not determine blood flow or oxygenation, being approximately 30% in a 0.5 cm wide and 2 cm long flap, and 0% in a 1.0 cm wide and 4 cm long flap, both with a width to length ratio of 1:4. Blood flow and oxygenation were preserved to a greater extent in the thick flaps (∼40%) than in the thin flaps (∼20%), in a 0.5 cm wide and 2 cm long flap. >Conclusions: The dissection of a random advancement flap results in hypoperfusion and oxygenation that cannot be predicted by the width to length ratio but depend on the length and thickness of the flap.
机译:>目的:目的是研究随机进展的皮瓣的尺寸(长度,宽度和厚度)与保留的组织灌注和充氧之间的关系。 >方法:在猪的腹侧举起皮瓣。皮瓣宽0.5或1.0厘米,薄(在皮下组织中途切开)或厚(向下切至肌筋膜)。使用激光多普勒测速仪测量组织灌注,并使用Licox系统测量沿皮瓣长度每0.5 cm的组织氧合(pO2)。组织温度通过高分辨率红外相机可视化。 >结果:从皮瓣的底部到皮瓣的末端,灌注和氧合逐渐减少,达到术前值(2.0 cm)的40%,离皮瓣的底部约20%(2.5 cm)。距皮瓣底部3.0 cm处几乎没有血流,也没有氧气张力。皮瓣的宽度与长度之比不能确定血流量或氧合,在0.5厘米宽和2厘米长的皮瓣中约为30%,在1.0厘米宽和4厘米长的皮瓣中约为0%,两者的宽度长度比为1:4。在0.5 cm宽,2 cm长的皮瓣中,厚皮瓣(〜40%)比薄皮瓣(〜20%)中的血流和氧合保留程度更高。 >结论:解剖随机前进的皮瓣会导致血流灌注不足和充氧,这无法通过长宽比来预测,而取决于皮瓣的长度和厚度。

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