局部加热诱导的皮肤血管扩张在重新内化和非内化深下腹膜穿孔器上
Hansje P Smeele1, Lisa Martin2, Sander M J van Kuijk3
1Department of Plastic, Reconstructive and Hand Surgery, GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands.
Microsurgery
|October 3, 2023
概括
在手术后的几年里,深下腹膜穿孔器 (DIEP) 板显示血液流动对加热的反应受损. 片重新内化并没有改善这种血管反应,这表明在自由片转移后存在长期缺陷.
科学领域:
- 整形外科 整形外科 整形外科
- 血管生物学 血管生物学
- 微手术 微手术是一种微手术.
背景情况:
- 皮肤血管对自由片局部加热的反应性尚不清楚.
- 深下腹膜穿孔器 (DIEP) 板通常用于乳房重建.
- 评估重新内化和非内化DIEP片的血管扩张对于了解片功能至关重要.
研究的目的:
- 为了评估局部加热诱导的皮肤血管扩张在reinnervated和noninnervated的DIEP片.
- 为了比较DIEP板和对侧原生母乳组织之间的血管反应性.
- 评估膜再内核对感觉神经功能和热感知的影响.
主要方法:
- 一项涉及21名接受单边延迟DIEP乳房重建的女性患者的横截面研究.
- 激光多普勒流量测量用于在局部加热期间测量DIEP板和逆侧乳房中的皮肤血液流量.
- 用触觉感知,热感知和热痛值来评估感觉神经功能.
主要成果:
- 与对侧乳房相比,DIEP板显示皮肤血管扩张显著减少 (p < .001).
- 在重新内核化和非内核化DIEP板之间没有观察到血管扩张的显著差异 (p = .75).
- 与非内内化片 (90%对36%,p=0.02) 相比,具有内内化片的患者中,报告的热痛低于安全值的比例更高.
结论:
- 自由转移导致局部加热诱导的皮肤血管扩张的持续损伤,影响感觉神经介导和依赖氧化的通路.
- 片重新内化并没有统计地改善皮肤对局部加热的血流反应.
- 这些发现突显了DIEP重建后的长期血管和感官缺陷.
更多相关视频
相关概念视频
01:10Mechanism of Angiogenesis
Blood vessel formation starts early during embryonic development, around day 7. In the extraembryonic yolk sac, mesodermal precursor cells called hemangioblast proliferate and differentiate into angioblast. Angioblasts express vascular endothelial growth factor receptor 2 or VEGFR2, which binds VEGF-A, a proangiogenic factor, guiding blood vessel formation. VEGF signaling promotes angioblasts to form a blood island in the developing embryo. Angioblasts further differentiate, giving rise to...
01:24Regulation of Angiogenesis and Blood Supply
Rapidly dividing tumors, embryos, and wounded tissues require more oxygen than usual, lowering the oxygen concentration in the blood. At low oxygen or hypoxic conditions, an oxygen-sensitive transcription factor called the hypoxia-inducible factor 1 or HIF1 is activated. HIF1 is a dimeric protein of alpha (ɑ) and beta (β) subunits. Under optimal oxygen conditions, HIF1β is present in the nucleus while HIF1ɑ remains in the cytosol. HIF1ɑ is hydroxylated by prolyl hydroxylase and factor...
01:16Vascular Spasm
The vascular phase, also known as vasospasm, is the initial stage of hemostasis, crucial for preventing excessive bleeding when a blood vessel is injured. After a vessel is cut, nerves in the damaged area trigger pain and other sensory impulses. Simultaneously, the smooth muscles in the vessel wall contract, resulting in a vascular spasm. This contraction reduces the vessel's diameter at the injury site, slowing or stopping blood loss through the vessel wall. Vascular spasms typically last for...
01:17Autoregulation of Blood Flow
Autoregulation mechanisms are characterized by their inherent capacity for self-regulation without necessitating specific nervous stimulation or endocrine control. These mechanisms facilitate the adjustment of blood flow and, therefore, perfusion specific to each tissue region. This self-regulation encompasses chemical signals and myogenic controls.
Chemical Signaling in Autoregulation
Chemical signaling operates at the precapillary sphincter level, inciting either contraction or relaxation.
Chemical Signaling in Autoregulation
Chemical signaling operates at the precapillary sphincter level, inciting either contraction or relaxation.