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Vasculature Characterization of a Multiterritory Perforator Flap: An Experimental Study
Long Wang1, Zong-Wei Zhou1, Liang-Hui Yang1
1Department of Hand and Plastic Surgery, The Second Affiliated Hospital and The Second Clinical Medical College of Wenzhou Medical University, Wenzhou, China.
Journal of Reconstructive Microsurgery
|January 19, 2017
Summary
Neovascularization, including arteriogenesis and angiogenesis, improves perforator flap survival by remodeling choke vessels and increasing microvessels. This vascularization is crucial for flap viability in dynamic and potential territories.
Area of Science:
- Vascular Surgery
- Tissue Engineering
- Regenerative Medicine
Background:
- Perforator flap tip necrosis is a significant clinical challenge.
- Understanding perforator flap vasculature is key to improving outcomes.
- A rat model was used to study multiterritory perforator flap vasculature.
Purpose of the Study:
- To characterize the vasculature of a multiterritory perforator flap.
- To investigate the impact of vasculature on flap survival.
- To analyze vascular changes in choke zones post-surgery.
Main Methods:
- Utilized 105 Sprague Dawley rats across seven postoperative time points.
- Performed multiterritory perforator flaps based on the deep iliac circumflex artery.
- Employed sodium fluorescein and lead oxide-gelatin angiography, alongside histological examination.
Main Results:
- Delayed staining observed in perforator flaps, particularly in the first and second choke zones (FCZ and SCZ).
- Choke vessel dilation occurred in the FCZ, while microvessel increase was noted in the SCZ.
- Neovascularization, including arteriogenesis and angiogenesis, was evident in surviving flap territories.
Conclusions:
- Vessel remodeling and microvessel proliferation contribute to flap survival.
- Arteriogenesis and angiogenesis are critical mechanisms for perforator flap viability.
- Neovascularization ensures survival in dynamic and parts of the potential flap territories.
