Clinical Multiple Factors Analysis Of Blood Transportation Obstacle Of Expanded Flaps After Transplantion

The flap transplantion is a routin treatment measure and is widely used by plastic surgons. Since the controlled skin tissue expander was developed by Radovan in 1976, expanded flaps have been the major source of clinical flaps. With patients' higher requirement to plastic operations,specialists have found that skin soft tissue expander can supply skin tissue and flaps which are similar with tissue of accepted region in color, luster, texture and thickness. Expansion effect can enhance blood supply and longthen the survival of expanded flaps, howere, the expanded flaps are associated with blood transportation obstacle after transplantion which would lead to operation failure.This thesis is composed of two parts:review of literatures and clinical practice.Dorctors have hoped the technology can be used easier following least complications, so all kinds of expanders have been invented and practiced. According to statistic result, after expansion, human epidermis is thicker, the dermis is thinner contrast with the epidermis and subcutaneous tissue becomes thinning significantly.Not only surface area of expanded skin is increased after expansion,but also its vascularity is augmented, the survival and vascularity of expanded flaps are increased. The tension after transplantion should be kept similarity to expanding tension.We made a retrospective analysis of 546 cases treated with skin expansion to study the influence factors related to blood transportation obstacle, in order to provide the guidelines for future clinical work.From January 2005 to February 2008 ,86 cases with blood transportation obstacle in 1256 cases of expanded flaps were reviewed and analyzed in different groups. There isn't relationship between male and female. Forane flaps have more risk than local flaps, even though they were transported with axial vessel or delayed 1-2 times. Hematoma, infection and ill-health of around tissue would increase the risk of blood transportation obstacle. Incident of blood transportation obstacle in neck and extremity flaps was significantly higher than in other parts.In conclusion, expansion technique of soft tissue can reach good cosmetic result. However, blood transportation obstacle increases the pain of patients, necrosis lead to failure of operations. We need to make further research on how to prevent blood transportation obstacle and reduce necrosis rate.