Animal Experimental And Clinical Application Study On The Relationship Between The Fixed Size Of Random Flap And The Ratio Of Length To Width Of Pedicle And On Vacuum Sealing Drainage Treatment

Objective ① Making animal model of the random flap with fixed size and different Length to width ratio.Observation in the process of healing flap and the expression of CD 105,VEGF,Caspase-3,and Ki67 on the survival process of slender narrow pedicle flap,to discuss the survival mechanism of the flap;② Making the extravasated blood flap animal model of the slender narrow pedicle flap.Application of Vacuum sealing drainage to improve the slender narrow pedicle flap blood supply,to discuss ways to promote slender narrow pedicle flap survival;③ And clinical applications.Methods ① basic experiment part 1:Making the animal model of random flap with fixed area of the plap and variable pedicle.Using 30 New Zealand White rabbits,we set two pairs flap on the each back side of each rabbit and designed every pair flap as 6.0cm diameter with a randomly aspect ratio from following ratios cases:0:2.0cm、1.0cm:2.0cm、2.0cm:2.0cm、3.0cm:2.0cm、4.0cm:2.0cm、5.0cm:2.0cm,.We got A,B,C,D,E,F five groups within 20 flaps by classifying the same ratio as a group,then through the overall observation,survival area measurement,flaps HE staining and qualitative and semi-quantitative analysis by immunohistochemical technique on CD 105,VEGF,and by Real-time Quantitative PCR on caspase-3,Ki67,after 1 hour and after 1 day,5 days and 7 days in every flap group.② basic experiment part 2:Making the extravasated blood flap animal model of the slender narrow pedicle flap.The flap pedicle length-width ratio of 5.0cm:2.0cm,each carrying diameter of 6cm size flap.The slender narrow pedicle flaps were created in two groups rabbits’ bilateral dorsum of 20 New Zealand white rabbits,Application of vacuum sealing drainage on experimental groups,Application of package on the other control groups.The flaps were evaluated with the general observation,and computerized analysis of survival area in 7 days postoperation.The full-thickness tissue specimen were cut down on the edge of each flap’s remote,which size was 0.5cm ×0.3cm,at days 3,5,and 7 after operation respectively.By HE staining,for observation the change of the flap tissue at different time point.③ clinical application:Collect all sorts of reasons caused by soft tissure defects of 50 cases,all soft tissure defects were repaired by the slender narrow pedicle flaps.Results ①When the flap has 6-centimeter diameter and 2-centimeter pedicle width,the flap survival area will not be changed by increasing the pedicle length,but the distal flap will experience necrosis when the length reaches to 4-centimeter,scilicet,the ratio of length to width is 4cm:2cm;② The organization analysis suggested that during the CD 105,VEGF surviving process in elongated narrow pedicle flap,because of the organization injury in surgery and ischemia and hypoxia response to organization,they have increased the quantity in organization with a peak after wise.Following the new blood vessels generated and mature,blood supply improved,CD 105,VEGF reduced gradually with a certain regularity.And what is more,the expression of Caspase-3 in the extravasated blood flap was increased on the first day after operation,then decreased,the expression of Ki67 rose in the first day after operation,maintained in high expression,and showed a certain regularity with the control group.③ Application of Vacuum sealing drainage can promote the slender narrow pedicle flap survival,flaps of experimental groups significantly reduce swelling,edema degree and the congestion situation improved significantly.④ The slender narrow pedicle flap is an ideal method for repairing the large soft tissue defect.Conclusions ①There is a maximum aspect ratio in the survival narrow pedicle pedicle under a certain area flap,increasing the aspect ratio in a specified range will not lead to flap necrosis Within a certain range,but beyond the range,flap will be necrosis;②CD105,VEGF,Caspase-3,Ki67 play important role in the survival process of the slender narrow pedicle flap.③ Application of Vacuum sealing drainage can promote the slender narrow pedicle flap survival.④ The slender narrow pedicle flap is an ideal method for repairing the soft tissue defect.