Experimental Study And Application Of Prefabricated Flaps On Animal Model With Severe Extremity Trauma

[Objective] It is a difficult problem that the defect of tissues at extremities while there have severe injury, especially when standard donor sites are not available or do not provide sufficient tissues, and its clinical therpeutic results is not confirmed satisfactory, not only by the doctors of trauma orthopaedices, but also by the patients troubled with this kind of diseases. A type of composite flaps which is similar to the compond defect of tissues is to be badly in need. Prefabricated flap is a kind of flaps which is designed and cultured according to the demonds of the reconstructive surgeons, the coloboma of tissues need of recipent areas. The special method is: to transfer a bandle of artery and vein vessels into a chosen donor site ,and implante it; after a period of time , raise the flap and transfer it as an island flap pedicled on the axillary vessels. Advantages of this technique is that it can make a flap without axillary vessels into one with axillary vessels on purpose. Using the concept of flap prefabrication, this study is designed to prefbricate a fasciocutaneous flap for treament of the severe extremities trauma, especially the defects of soft tissues. In this study, immediate reinnervation in flap prefabricatin is investigated.[Methods] Fifteen New Zealand white rabbits were divided into three group according to the vessels which were ready to be implanted. Group A was the ones that the inferior epigastric artery and vein would be implanted ; Group B was the ones that the external pedendal artery and vein would be implanted; Group C was the ones that the femoral artery and vein, the part of femoral nerve would be implanted.Operative method: After the vessels were found and separatd, the inferior epigastric vascular pedicle was transferred and implanted subcutaneously in the super abdomen; the external pedendal vascular pedicle was transferred and implanted subcutaneously in the lower abdomen; the femoral vascular pedicle was transferred and implanted subcutaneously in the lower abdomen .While the secondry operation ,one sheet of skin and fascia at the rabbit's lower limp was cut and moved away, by this way, we harvested a rabbit model with severe extremity injury.Observation method: Three weeks later ,we had the secondry operation. The prefabricated flaps were separated and raised as island flaps connected only to the pedicle. The first, the flap viability was assessed visually; the secondary, the range of neovascularization was evaluatedby means of dye injection with ink;the third ,the flaps was rotated and transferred to the defect area on the lower limp;the fourth, the tssue where the pedicle was inserted was cut and avalued by histological examination.[Results] There were none of infection, limp necrosis, limp complete paralysis and death overall. Two cases were failed because of the pedicle shedding.The other flaps had good blood circulation after they were raised. The biodistribuion studies of ink revealed that the flaps were revascularized fully. Being transferred , the flaps were observed directly aftr ten days, flaps were total...