The experimental study of shunt-decompression arterialized vein flap

Area of Science:

• Regenerative Medicine
• Vascular Surgery
• Fluid Mechanics in Biology

Background:

• Arterialized vein flaps present physiological limitations, leading to complications like swelling, blood stasis, and necrosis.
• Unphysiological blood circulation in traditional flaps increases load, compromising graft survival.
• Current flap grafting methods require improvement to mitigate associated risks.

Purpose of the Study:

• To introduce a shunt-decompression surgical technique for arterialized vein flaps.
• To reduce circulation preload and improve flap survival rates.
• To apply fluid mechanics principles to enhance flap grafting outcomes.

Main Methods:

• A shunt-decompression arterialized vein flap model was developed based on Bernoulli's principle.
• End-to-side anastomosis was performed between the arterialized vein and recipient artery branches.
• Animal experiments in mini pigs assessed flap perfusion, blood flow, swelling, and survival using Doppler speckle perfusion imaging.

Main Results:

• The experimental group showed significantly reduced flap perfusion (83.62 PU) compared to the control group (98.14 PU) (P < 0.05).
• Flap survival was significantly improved in the experimental group, with 7 flaps completely surviving versus 3 in the control group (P < 0.05).
• Necrosis rates were substantially lower in the experimental group, with no complete necrosis observed.

Conclusions:

• The shunt-decompression strategy effectively reduces arterialized vein flap perfusion.
• This improved anastomosis technique enhances flap survival and minimizes complications.
• The findings provide valuable insights for the clinical application of arterialized vein flaps.