Experimental Rat Skin Flap Model That Distinguishes between Venous Congestion and Arterial Ischemia: The Reverse U-Shaped Bipedicled Superficial Inferior Epigastric Artery and Venous System Flap

Matsumoto, Noriko; Aoki, Masayoshi; Nakao, Junichi; Peng, Wei-Xia; Takami, Yoshihiro; Umezawa, Hiroki; Akaishi, Satoshi; Ohashi, Ryuji; Naito, Zenya; Ogawa, Rei

doi:10.1097/prs.0000000000002900

Cited by 14 publications

(9 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[1][2][3][4] By fully understanding the characteristics of the choke vessels and true anastomosis, the flap can be raised safely in most cases, but exceptions can happen. 8 The study of Matsumoto et al 10 showed that the choke vessels might not have equal flow carrying capabilities in the rat SIEA model.…”

Section: Discussionmentioning

confidence: 99%

“…This paper claimed that ischemia or congestion happened after vessel ligation, and the distal angiosome was lost in both the arterial and venous ligation groups. 10 Their findings raise 2 important observations. First, the 2-territory flap is expected to survive based on a single pedicle.…”

mentioning

confidence: 90%

“…Animal studies have previously demonstrated that a rectangle SIEA flap, much larger than this U-flap, survived completely. [10][11][12][13] The second observation is that, after ligating the distal artery or vein, the remaining vessel is expected to supercharge or turbocharge the flap. However, the distal angiosome still failed to survive.…”

mentioning

confidence: 99%

“…Matsumoto et al 10 introduced a reverse U-shaped superficial inferior epigastric artery (SIEA) flap model. This skin flap consists of 2 angiosomes and has the SIEA to supply the flap from both sides.…”

mentioning

confidence: 99%

See 3 more Smart Citations

Identification of Unequal Flow-Carrying Capabilities of Choke Vessels in Rat Abdominal Flaps

Zhu

Xiao

et al. 2022

Ann Plast Surg

View full text Add to dashboard Cite

Background: Although the angiosome concept is a well-accepted theory, unexpected necrosis suggests that other factors can influence the flap survival. Our study uses the rat model to explore the flow capacity of the choke vessels across 2 angiosomes. Methods: The medioventral line of Sprague-Dawley rats' abdominal flap was equally divided into 4 sections, which were preserved in 7 different groups (n = 6/group): A, no dissection; B to D, preserve the inferior 1/4, 2/4, and 3/4 sections; E to G, preserve the superior 1/4, 2/4, and 3/4 sections. The ratio (%) of the survival area of the distal/ proximal territory was calculated. Indocyanine green, lead-oxide gel imaging, hematoxylin and eosin, and CD31 histology tests were performed. Results: Compared with 96.0 ± 1.4% flap survival in group A, groups B, C, and D had distal territory flap loss (34.8% ± 4.1%, 65.0% ± 3.7%, and 94.3% ± 3.1% respectively). Group E lost the majority of the distal territory (3.5% ± 2.4%), whereas groups F and G (15.5% ± 3.8% and 79.2% ± 3.3%, respectively) had larger flap survival. Except for groups A and D, each of the other 2 groups showed statistically significant results (P < 0.001). Indocyanine green indicated no blood flow at the superior 1/4 part. Lead-oxide gel and histology showed that the choke vessels residing along the medioventral line had no significant difference. Conclusions: Choke vessels do not carry blood flow equally. Two categories of choke vessels-"resting" and "active"-are proposed. The "active" form has variable flow carrying capabilities when the flap is harvested in different designs.

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 90%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Identification of Unequal Flow-Carrying Capabilities of Choke Vessels in Rat Abdominal Flaps

Zhu

Xiao

et al. 2022

Ann Plast Surg

View full text Add to dashboard Cite

show abstract

“…During the ischemic period several changes take an effect on the skin flap, such as endothelial damage, capillary thrombosis, among others 2,29,32,33 . All can affect the wound healing of the flap.…”

Section: ■ Discussionmentioning

confidence: 99%

Effect of short-term ischemia on microcirculation and wound healing of adipocutaneous flaps in the rat

et al. 2019

View full text Add to dashboard Cite

show abstract

Monitoring Vascular Compromise Using Ultrasound After Free Tissue Transfer

Shinomiya

Sunagawa

Nakashima

et al. 2019

J of Ultrasound Medicine

View full text Add to dashboard Cite

Objectives-To report the clinical utility of high-resolution ultrasound (US) for monitoring vascular compromise after free tissue transfer.Methods-Fifty-two tissue transfers in the extremities were included in this study. Blood flow around the anastomotic pedicle and subcutaneous tissue of the grafted flap was monitored with pulsed color and power Doppler US whenever the conventional monitoring method, comprising the bedside assessment of the temperature, capillary refill, and flap color, showed abnormalities until 1 week after reconstruction.Results-All flaps were indicated for US monitoring, with 44 flaps showing Doppler signals in each position, even though conventional flap monitoring showed an abnormality. Forty of the 44 flaps showed no flap failure, whereas the remaining 4 flaps developed partial necrosis. Abnormal US findings were noted in 8 of the 52 flaps. Ultrasound revealed interruption of venous blood flow around the anastomotic pedicle in 6 of 8 flaps. Emergent exploration revealed venous occlusion at the anastomotic pedicle, similar to the US finding. In 2 of the 8 flaps, US showed no blood flow to either the anastomotic pedicle or subcutaneous tissue. Emergent exploration revealed arterial occlusion at the anastomotic pedicle. Seven of the 8 reexplored flaps were salvaged after revision surgery with complete flap survival. Partial flap survival was noted in 1 case, but complete flap failure was avoided.Conclusions-Ultrasound is a useful adjunct that enables a direct assessment of perfusion in grafted tissues, which may reduce unnecessary exploration when conventional flap monitoring shows an abnormality.

show abstract

Experimental Rat Skin Flap Model That Distinguishes between Venous Congestion and Arterial Ischemia: The Reverse U-Shaped Bipedicled Superficial Inferior Epigastric Artery and Venous System Flap

Abstract: The flap facilitated discrimination of the effects of ischemia and congestion. This new rat skin flap model is simple and easy to construct, and has a consistent flap survival rate.

Cited by 14 publications

References 28 publications

Identification of Unequal Flow-Carrying Capabilities of Choke Vessels in Rat Abdominal Flaps

Identification of Unequal Flow-Carrying Capabilities of Choke Vessels in Rat Abdominal Flaps

Effect of short-term ischemia on microcirculation and wound healing of adipocutaneous flaps in the rat

Monitoring Vascular Compromise Using Ultrasound After Free Tissue Transfer

Contact Info

Product

Resources

About