Axial Pattern Flap In Rats And The Radiation Damage To Low-energy Shock Wave Treatment Of Experimental Study

Skin flap as soft restored, color close to the affected area, suitable for repairing a variety of different soft tissue defects. However, flap also variation due to vascular flap was too large, vascular spasm, thrombosis, infection, ischemia reperfusion injury, resulting in inadequate distal blood perfusion and ischemic necrosis. The flap ischemia, often with physical warmth, vasodilator drugs, anticoagulant drugs to reduce ischemia-reperfusion injury drugs can increase the amount of flap tissue perfusion, but also can be applied to the growth of all involved in angiogenesis factors such as vascular endothelial growth factor (VEGF), transforming growth factor (TGF) preoperative or postoperative stimulation of angiogenesis, thus improving skin flap ischemia. At the same time flap delay, expansion, pre-ischemic treatment after surgical methods can reduce the risk of flap necrosis and flap harvested area expansion. But the surgical approach and second surgery, to increase economic and psychological burden of patients; cell factor as high cost, short half-life after entering the body, various types of recombinant cell growth factor long-term effects on the human body is also limited understanding of the reasons for lack of clinical promote the application. Drug Application by the large number of systemic side effects can not be ignored. So there has to be economical and effective, it means fewer side effects to the treatment of ischemic skin flap. Extracorporeal shock wave therapy (ESWT) has been 20 years, but in orthopedic surgery and trauma treatment is relatively new method, because of its good effect to promote angiogenesis, has been used nonunion, bone necrosis, bone tendon muscular system parts and other non-invasive treatment. Recent studies show that extracorporeal shock wave therapy to promote angiogenesis and increase perfusion of ischemic tissue, reduce inflammation, increase cell differentiation and promote wound repair. Some scholars reported that extracorporeal shock wave therapy can improve the flap survival rate. Extracorporeal shock wave therapy for avoiding surgery, safe, effective and reliable than open surgery prices more reasonable application of non-invasive treatment of ischemic flap changes to resolve possible, but the best energy extracorporeal shock wave treatment of choice, the right impact frequency, and the different treatment of ischemic tissue and biological changes, etc., need further study.In this paper, to be adoptedâ‘ anatomical study of the blood vessels in rats back, in order to stabilize the back flap in rat model of preparation, to provide a reliable anatomical data to prove that the different blood supply skin flap preparation, the impact of the flap model;â‘¡to be adopted by the back flap in rat model, the application 0.18mj/mm2 single-point impact energy, the view 500 pulses and 250 pulses the impact of treatment of stage (a total of 500 pulses) the impact of treatment on the model of the impact of skin flap blood supply;â‘¢to be adopted by large rats after irradiation, radiation back flap model, applied a simple low-energy shock wave therapy group, bone marrow cell suspension injection group, simple flap model group, bone marrow cell injection of shock wave therapy group, PBS injection group, such as observed between the two groups to explore the shock wave therapy on radiation injury of skin flap viability and a reasonable mode of action.In this paper, back through the vascular network in ratâ‘ anatomical study found that there is four groups of rat back skin-vessel network structure, and four groups on both sides of the formation of vascular network in the back of a wide range of vascular anastomosis, in which thoracic lateral cutaneous branch and the circumflex iliac artery deep artery perforating branches to form a vascular network stability, and can be used as rat back flap of the blood vessels. In rats of three different groups back 2.5cmX10cm blood pattern flap model comparisons without a network of arteries and the off-axis bit random flap artery network model of the survival rate of less than 50%, but the back and chest side-branch artery skin flap can reach the survival rate of more than 82.70%;â‘¡rat back flap of the shock wave therapy was found 0.18mJ/mm2 single point of shock wave therapy in 500 pulses and 250 pulses the impact of the number of stages shock therapy to improve flap survival area were the role of general observation of the treatment is better than the survival rate of 250 pulses 500 pulses the impact of phased treatment, translucent observation 250 pulses the impact of the treatment group capillary density was significantly better than 500 pulses the impact of the treatment group, and there statistical significance;â‘¢flap model for radiation injury in the shock wave therapy found that the survival rate of the general observations of bone marrow cells were injected flap combined effect of shock wave therapy group the highest, followed by a simple flap after radiation injury, bone marrow cells were injected group and a simple shock wave therapy Group flap necrosis evident. HE staining under light microscope observation found in bone marrow cells combined with shock wave therapy group of skin layers of tissue damage is relatively small structure to save the most complete, other groups necrosis apparent structural disorder. VEGF immunohistochemical staining positive specimens observed the highest rate of combined therapy group.Through the axial pattern skin flap in rats and their radiation damage to low-energy shock wave therapy can be drawn from a series of studiesâ‘ only has a good blood supply system, axial flap, the flap can provide a stable model;â‘¡The experimental application of shock wave therapy , have a therapeutic effect of axial pattern skin flap, but the impact was more low-dose repeated;â‘¢In this study, a simple shock wave therapy and bone marrow cells injection in the treatment of radiation injury in flap model, non-catalytic role;â‘£bone marrow cell injection combined with shock wave treatment can effectively control the state of deterioration of skin flap.The innovation of this study:â‘ the first time on the dorsal vascular network of the system anatomy, for the preparation of rat dorsal skin flap model to provide anatomical data, the experiment proved the importance of standardized model;â‘¡the first demonstration of 0.18mJ/mm2 energy shock wave therapy has increased the role of flap survival, and repeated small doses of pulse therapy, is better than a single large dose of shock therapy, no published abroad;â‘¢first flap model for radiation injury in low-energy shock wave therapy, and that cell therapy combined with radiation injury flap shock wave therapy effective, simple application of cell therapy and shock wave therapy is ineffective, not been published at home and abroad.