Experimental Study On Dynamic Expression Of D-dimer And F1+2During Early Venous Crisis After Free Perforator Flap Transplantation

Object To investigate the dynamic expression of D-dimer and F1+2during early venous crisis in order to find a novel and reliable method to warn venous crisis after free perforator flap transplantation.Methods Thirty healthy New Zealand white rabbits were chosen and randomly divided into experimental group (n=15) and control group (n=15), all of them were transplanted with free superficial epigastric artery perforator flap. The anastomosis veins were ligated in the experimental group in order to interrupt the blood outflow of perforator flap to form venous crisis. Intervening measures were not implemented in the control group. All of Rabbits were drawn peripheral arterial blood in preset time. The blood supply of all flaps was monitored. The concentration of D-dimer and F1+2of peripheral blood were detected with ELISA. An amount of flap tissue were harvested for pathological observation. Data analysis was performed by using SPSS17.0statistical software. Ap value of <0.05was considered statistically significant.Results The concentration of D-dimer in both two groups increased at three time points of preoperative, flap reflow immediately, ligating vein immediately. However, there is no obvious differences between two groups. With venous crisis of flap occurring, the concentration of D-dimer significantly increased. Conversely, It decreased in the control group.The concentration of D-dimer began to appear obviously statistical difference at15minutes after the outflow vein being ligated. Since then, the concentration of D-dimer in two group subtly changed. But the difference has statistical significance between the two groups(P<0.05). Compared with the control group, the differences of the concentration of F1+2in peripheral blood between the two groups have no statistical significance(P>0.05) at three time points of preoperative, flap reflow immediately, ligating vein immediately. With occurrence of venous crisis of flap, the concentration of F1+2significantly increased. Conversely, It decreased in the control group.The concentration of F1+2began to appear obviously statistical difference at15minutes after the outflow vein being ligated. Since then, the concentration of F1+2in two group subtly changed. But the difference has statistical significance between the two groups(P<0.05).Conclusion At the time point of15minutes after the outflow vein being ligated, both D-dimer and F1+2increased obviously, they maybe become the alarm signs of early venous crisis.