Experimental Study On Facilitating The Survival Of Slender Narrow Pedicle By The Application Of Vacuum Sealing Drainage

Objective: To probe into the application of vacuum sealing drainage to slender narrow pedicle and observe the survival of the pedicle, to observe the shaping of blood vessel in the skin flap, the congested edema in the tissue and the expression of CD34 in the skin flap, to analyze the functioning law of vacuum sealing drainage to the skin flap.Method: 64 SD rats were divided into 8 groups in random. A flap was designed and put on either side of a rat's back, and altogether 128 flaps were created. The flap was designed in the shape of a table tennis. The width and the length of the flap were both 0.8cm and the pedicle was with the diameter of 3.5cm. And the flaps on one side of the rats'backs were randomly arranged into control side, and the flaps on the other side served as the experiment side. The 8 groups divided at first were named respectively after the time of the experiment: the instant group, the four-hour group, the eight-hour group, the one-day group, the two-day group, the three-day group, the four-day group, and the six-day group. And the control group and the experiment group were further divided within each of these eight groups. So did the experiment groups. The equipment of vacuum sealing drainage was fixed sideways to each group after the shaping of flaps. Each of the equipments in the groups was dismantled instantly after the operation, or four hours, eight hours, one day, two days, three days, four days and six days respectively after the operation. Afterwards the color and swelling degree of the flaps were observed, a sample with the size of 0.3cm×0.5cm was cut and the flap survival area was measured altogether on the seventh day. The expressions of flap histology and CD34 were observed mainly through HE dyeing and immunohistochemistry. The statistical data were treated to figure out the flap survival rate and determine whether statistical differences lie in the neovascularized microvessel density (MVD) in the flaps.Results: 1,As the time of the negative pressure suction went on, the survival area of the side flap under experiment was increasing day by day and came to the maximum on the third day, but no statistical difference was discerned between on the third day and on the sixth day (P>0.05).2,No statistical difference existed to the flap survival areas of the respective control side and experiment side in the instant group, the four-hour group, the eight-hour group and the one-day group. However, statistical differences did exist to the flap survival areas of the respective control side and experiment side in the two-day group, three-day group, four-day group and six-day group (P<0.05).3,As the time of the negative pressure suction went on, the MVD in the flap was increasing. Statistical differences (P<0.05) existed between the experiment side of the instant group, the four-hour group and the eight-hour group and those of the three-day group, the four-day group, and the six-day group, between the three-day group and the four-day group, between the three-day group and the six-day group. However, no statistical difference existed between the four-day group and the six-day group (P>0.05).4,The swelling, edema and congestion of side flaps under experiment were obviously mitigated compared with those under control.Conclusion: The application of vacuum sealing drainage can advance the survival of the skin flap, whose survival area can meet its maximum within three days under application. Besides, the application of vacuum sealing drainage can encourage the increase of MVD in the flap and further contribute to the neovascularization, as well as improve the congested edema in the flap.