The influence of arterial flow resistance and venous flow resistance of the choke area on the survival of perforator flap
CHENG Sheng, XI Shan-shan, HE Yao-zhi, MEI Jin, DING Mao-chao
Chinese Journal of Clinical Anatomy ›› 2018, Vol. 36 ›› Issue (6) : 648-651.
The influence of arterial flow resistance and venous flow resistance of the choke area on the survival of perforator flap
Objective To investigate the arterial resistance and venous resistance of blood flow across the choke vessels and their effects on the survival of perforator flap, through comparative study of the arterial and venous resistance in the same group of flaps. Methods Thirty-four Sprague-Dawley rats were randomly divided into two groups: group A preserved the right intercostal posterior artery and the left intercostal posterior vein, and group B preserved the right intercostal posterior artery and the right iliolumbar vein. The distance between the reserved artery and vein was measured. At day 7 after surgery, the survival rate of the flap was measured and the microvascular morphology was observed through lead oxide-gelatin angiography; Tissues were harvested from the choke area, which then underwent H＆E staining to measure the average microvascular density; Moreover, blood was collected from the tail vein for detection of the contents of lactate. Results The distance between the preserved artery and vein in group A was shorter than that in group B, the difference was statistically significant (P<0.05). At day 7 after surgery, the survival rate of group A was 100 percent, while in group B the survival rate of angiosome 1, angiosome 4 and the whole flap was（67.0±13.1）%, 100% and （88.0±6.8）%, respectively; the angiogenesis was more obvious in group A than that in group B, and the difference was statistically significant (P<0.05); the lactate contents in group A and group B were both close to the preoperative level, and the difference was not statistically significant (P>0.05). Conclusion ① The venous resistance of blood flow across the choke vessel is greater than that of the arterial resistance; ② It is helpful to reduce the venous resistance of blood flow across the choke vessel and improve the survival rate of the flap by shortening the unilateral distance of the arterial and venous blood flow across the choke area.
Choke vessel / Arterial resistance / Venous resistance / Perforator flap
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