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Preliminary Exploration: When Angiosome Meets Prefabricated Flaps.

Heng Xu1, Zheng Zhang1, Yimeng Xia2

  • 1Department of Plastic Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Journal of Reconstructive Microsurgery
|July 26, 2016
PubMed
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Angiosomes can limit blood flow in prefabricated flaps, but new blood vessels can overcome this. This study in rats shows cross-bound neovascularization improves flap survival by bypassing these limitations.

Area of Science:

  • Plastic Surgery
  • Regenerative Medicine
  • Vascular Biology

Background:

  • Prefabricated flaps have limited survival areas, potentially due to insufficient neovascularization.
  • The innate vascular network of flaps and the concept of angiosomes may create conflicting theories on blood perfusion.
  • This study investigates the role of angiosomes in prefabricated flap survival.

Purpose of the Study:

  • To determine if angiosomes impede blood perfusion in prefabricated flaps.
  • To investigate the impact of neovascularization time and pedicle orientation on flap survival.
  • To elucidate the mechanisms of blood supply in prefabricated flaps.

Main Methods:

  • A two-stage operation of a prefabricated abdominal flap was performed in a rat model.

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  • Rats were divided into five groups with varying pedicle angles and prefabrication times (2-3 weeks).
  • Macroscopic appearance, near-infrared fluorescence imaging, and capillary density were analyzed.
  • Main Results:

    • No significant difference in survival area between horizontal and oblique pedicle angles (Groups A & B).
    • Vertical pedicle angle (Group C) showed significantly smaller survival area than the horizontal pedicle in the same position (Group D).
    • Angiosome boundaries limited perfusion in some groups, while cross-bound neovascularization in Groups A & D improved it. Capillary density correlated positively with neovascularization time.

    Conclusions:

    • Angiosomes act as a barrier to blood perfusion in prefabricated flaps.
    • Cross-bound neovascular vessels are crucial for nourishing prefabricated flaps and overcoming angiosome limitations.
    • Optimizing neovascularization strategies can enhance prefabricated flap survival.