Study On The Haemodynamics Difference Between Ultra-thin Perforator Flap And Perforator Flap In Miniature Swine

Objective: Establish ultra-thin perforator flap and perforator flap animal model; toassess the hemodynamic dynamic changes in the ultra-thin perforating flap andperforator flap; to understand the haemodynamics difference between ultra-thin perforatorflap and perforator flap. To provide the basic experimental study for clinical ultra-thin flapsurvival rate.Methods:20(male10，female10) healthy adult Bama miniature pigs of similar weightwere chose with the bilateral abdominal perforator flap based on the SEA.They wererandomly divided into ultra-thin perforator flap group and perforator flap group. SkinPerfusions of both groups were detected by Laser Doppler Blood Perfusion Imagerpreoperatively and at postoperative2h,3d,lw,2w,3w. Hemodynamics in the SEAs (meanvelocities，diameters) were evaluated by Color Dopplex Ultrasonography at the same time.Calculate the superior epigastric artery blood flow was calculated. Correspondingly Visualevaluation was documented in series.Results:1、Flap visual evaluation:20flaps all survived in two groups. Flap edemahave reached peak at Postoperative3day in two groups; Edema in the ultra-thin perforatorflap group was more serious than that of the perforator flap group；At Postoperative1w，edema receded in both groups and edema in the ultra-thin perforator flap group was moreserious than that of the perforator flap group；At Postoperative2w and3w，there is nosignificant difference on the visual evaluation of the ultra-thin perforator flap group and theperforator flap group.2、The data of flap perfusion： Within postoperative lw, flap perfusion in twogroups showed an upward trend and increased markedly compared with that inpreoperation. There was a statistically significant difference (P <0.05)；the flap perfusion was significantly lower in the ultra-thin perforator flap group compared with the perforatorflap group. Skin blood circulation in ultra-thin perforator flap group was worse, and therewas a significant difference (P <0.05); At postoperative2w and3w, flap perfusion in twogroups was slightly larger compared with that in preoperation and there was significantdifference (P<0.05)；Iin flap perfusion between two group, there was no significantdifference (P>0.05)。3、Hemodynamics data: Within postoperative lw，The SEA average velocity intwo groups showed an upward trend and significantly increased, compared with that inpreoperation. There is a statistically significant difference (P <0.05). SEA average velocitywas significantly lower in the ultra-thin perforator flap group compared with the perforatorflap group, and there was significant difference (P <0.05) between two groups. Atpostoperative2w and3w, the SEA average velocity in both groups maintained the highlevel at postoperative1w, but the SEA average velocity was significantly lower in theultra-thin perforator flap group compared with the perforator flap group, and there was astatistical difference (P <0.05)；Within postoperative lw，The SEA blood flow of twogroups showed an upward trend and significantly increased, compared with that inpreoperation. There was a statistically significant difference (P <0.05). The SEA bloodflow was significantly lower at the ultra-thin perforator flap group compared with theperforator flap group, and there was significant difference (P <0.05) between two groups.At postoperative2w and3w, The SEA blood flow in both groups maintained the high levelat postoperative1w, but the SEA average velocity was significantly lower at the ultra-thinperforator flap group compared with the perforator flap group, and there was statisticaldifference (P <0.05)； At postoperative2h, SEA diameter in two groups increasedsignificantly compared with that in preoperation, and there is a statistically significantdifference (P <0.05). At postoperative3d,1w,2w and3w, SEA diameter in both groupshad no obvious changes, compared with that at postoperative2h, and there was nosignificant difference (P>0.05)。Conclusion: Miniature swine is the desirable model for the basic study of Ultra-thin perforators flap and perforators flap; Ultra-thin perforators flap have relatively lower skinblood perfusion compared with the perforators flap, which is the reason why Ultra-thinperforators flap survival area is smaller. Low velocity and blood flow of ultra-thinperforators flap pedicle vessel increases the risk of vascular anastomotic thrombosis, whichresults in much higher failure rate of free ultra-thin perforators flap is much higher thanperforators flap.