Effects of short-term venous augmentation on the improvement of flap survival-An experimental study in rats

摘要

Introduction: Flap necrosis due to blood circulation disorders is a serious problem in reconstructive surgery. Methods to achieve both arterial and venous microvascular augmentation at the flap periphery have therefore been developed to prevent post-surgical circulation problems, especially for large pedicle flaps and free flaps containing three more vascular territories. Moreover, the benefits of microvascular venous augmentation (VA; superdrainage) alone have been established, but the optimal duration of post-surgical venous drainage has not yet been determined. Methods: The surviving flap area was compared after standard and short-term VA in the extended island flap model of the rat abdomen. A flap model using the left superficial inferior epigastric artery/vein as the vascular pedicle was used as a control group (n = 6). The lateral branch of the right superficial inferior epigastric vein remained unresected at the end of the flap in the VA group (n = 7), but was ligated at 24 h post-surgery in the temporary venous augmentation (TVA) group (n = 7). Results: The flap survival rates on postoperative day 7 in the control, VA and TVA groups were 74.8 ± 8.4%, 90.1 ± 3.7% and 89.9 ± 3.5%, respectively. The surviving areas were significantly improved in the VA and TVA groups in comparison to the control group (p 0.01), but there was no significant difference between the VA and TVA groups. Conclusions: The short-term venous drainage from the flap end after surgery was as effective as long-term VA. Flap transplantation could therefore be clinically easier and more reliable when starting short-term venous drainage during surgery.