Research Of New Negative-pressure Suction Device For The Treatment Of Venous Congestion Flap

Objective:By using classical abdomen skin flap model of rabbit toobserve and compare the new negative-pressure suction device with theconventional negative-pressure suction device for the treatment of venouscongestion flap.To explore the effectiveness of the new negative-pressuresuction device in treating venous congestion flap, aims at providing theoreticalbasis of the new type negative-pressure suction device is widely used inclinical.Methods:15New Zealand white rabbits are needed, each rabbit do twolower abdomen axial pattern skin flaps, a total of30flaps venous congestionflap model. Using the random number allocation method,30flaps can bedivided into three groups of10flaps, named new negative-pressure suctiondevice group with new suction device, conventionalnegative-pressure suction device group with conventional suction device, nonegative-pressure suction device group (control group) with no treatment.They are processed and observed respectively. By random numbers within thedistribution method for each group of10flaps can be divided into6flaps fordrawing materials and4flaps for not. Flaps for drawing materials wereobserved for flaps color, swelling, finger pressure reflect in five time points of4hours (h),8hours (h),24hours (h),3days (d),7days (d) after surgery. Alsomeasured the flaps temperature and using flow cytometry to detected flaptissue cells in S phase ratio (S-phase fraction, SPF) and cell apoptosis.Threegroups of non-drawn flaps were measured flap survival area after7daysvenous congestion flap surgeryResult:1General observation result: After4h,8h,24h flaps in each groups wereswelling and distal dark purple areas were formed. In7thday after surgery, dark brown crust forming the boundaries of normal skin of each flaps wererelatively obvious, visible dark brown crust areas of the new negative-pressuresuction device group were smaller than conventional negative-pressure suctiondevice group，and ones of the conventional negative-pressure suction devicegroup were smaller than the no negative-pressure suction device group. Ineach group necrotic area in7thday after surgery is no significant differencebetween the expression in3th. On the7thday after the surgery, black scab skinhas been formed, with normal skin boundaries significantly.2Flaps surface temperature measurement result: Measured surface skintemperature of new negative-pressure suction device group and conventionalnegative-pressure suction device and no negative-pressure suction devicegroup before surgery, and the skin temperatures of three groups were nostatistics significance (P>0.05). In4h、8h、24h、3d、7d after theoperation, surface skin temperature of three groups were measured, skintemperature of postoperative groups were significantly lower thanpreoperative ones, but three groups of skin temperature has increased overtime.The skin temperature of new negative-pressure suction device grouprecovered the most fast. The skin temperature of new negative-pressuresuction device group is higher than the conventional pressure suction devicegroup,and conventional pressure suction device group is higher than nopressure suction device group, the difference was statistically significant (P <0.05).7days after the surgery, three groups have rehabilitated preoperativeskin temperature level, skin temperature there was no significant differencebetween the three groups at the time(P>0.05).3Skin flap survival area measurement results: In the7th day after surgery,skin flap survival area with necrosis area have been distinguish himself, and tomake an assessment of skin flap necrosis area. Statistics show that the survivalarea size of flaps among the three groups were statistically significantdifference (P<0.05). The new flap survival pressure suction device groupbigger than conventional flap survival area of negative pressure suction devicegroup, normal pressure suction device group flap survival area greater than no pressure suction device flap survival area. The flap survival areas of newnegative-pressure suction device group were larger than conventionalnegative-pressure suction device group,and conventional negative-pressuresuction device group flap survival areas were larger than the nonegative-pressure suction device group. The survival flap mean area of newnegative-pressure suction device group was (47.37±0.18)cm2, conventionalnegative-pressure suction device group was (45.10±0.48)cm2, nonegative-pressure suction device group was(39.96±1.44)cm2.4By flow cytometry test results:4.1The cell cycle of flap tissue: Measured S-phase fraction of flaps of newnegative-pressure suction device group, conventional negative-pressuresuction device group and no negative-pressure suction device group beforesurgery,and it is no significant difference in statistical analysis (P>0.05). It isdetected S-phase fraction of the three groups flaps by flow cytometry in fivetime point such as4h、8h、24h、3d、7d after surgery. The flap S-phase fractionof the new negative-pressure suction device group and conventionalnegative-pressure suction device group has increased obviously in4hoursafter the operation, and the peak appears in8hours after the operation, and thenew negative-pressure suction device group of S-phase fraction are higherthan conventional negative-pressure suction device group. But in24hoursafter the operation, no negative-pressure suction device group began to showgrowth trend, the peak is delayed until3days after surgery. In8hours and24hours after surgery, the proliferation of new negative-pressure suction devicegroup is the most significant in new negative-pressure suction device group,conventional negative-pressure suction device group and nonegative-pressure suction device group (P<0.05),mainly for the S-phasefraction increased significantly.4.2The cell apoptosis in early stage of flap tissue: Measured cell apoptosis inearly stage of flaps of new negative-pressure suction device group andconventional negative-pressure suction device group and no negative-pressuresuction device group before surgery,and it is no significant difference in statistical analysis (P>0.05). It is detected cell apoptosis in early stage of thethree groups flaps by flow cytometry in five time point such as4h、8h、24h、3d、7d after surgery. After4hours、8hours、24hours、3days in each groupcell apoptosis in early stage of flap increases, and the peak appears in24hoursafter the operation. The cell apoptosis in early stage of flap in newnegative-pressure suction device group is the most minimal in newnegative-pressure suction device group, conventional negative-pressuresuction device group and no negative-pressure suction device group, amongthe three groups had statistically significant differences (P<0.05). In7daysafter surgery, cell apoptosis in early stage of flap in new negative-pressuresuction device group and conventional negative-pressure suction devicegroup are less than no negative-pressure suction device group(P<0.05), andthe new pressure suction device group with no significant difference betweenthe conventional pressure suction device group(P>0.05).Conclusion：New negative-pressure suction device can reduce the degreeof venous congestion flap of swelling, improve the microcirculation to recoverblood flow of venous congestion flap and skin temperature as soon as possible.Placing the new negative-pressure suction device in the early period at thebottom of flap can promote the proliferation and reduce the apoptosis of tissuecells,and effectively reduce the necrosis area for venous congestion flap.Comparing to conventional negative-pressure suction device, newnegative-pressure suction device for the prevention and treatment of venouscongestion flap has a better effect.Effective, simple and cheap as it is, the newnegative-pressure suction device is worthy of popularization and application...