Experimental Study On The Superficial Inferior Epigastric Artery Free Flap Anastomosis Of Rabbit Models By Intravascular Stent Of Artificial Small Vascular Bridging

Part ?: Microvascular Anastomosis Training and ExperimentObjective: To design an appropriate time course and training program on the basis of personal experience so as to provide references for the standardized training of plastic surgery residents mastering microvascular anastomosis techniques.Methods: Four stages of gradually reinforced and discontinuous microvascular anastomosis training were carried out on different training models;before and after the training of microsurgical techniques,the anastomosis time,anastomotic stoma bleeding,vessels patency and survival rate of flap were assessed respectively.Results: After 150 days of discontinuous microsurgical training,the author was gradually skilled at the operation under microscopy,the anastomosis time of superficial inferior epigastric artery was reduced from(42 ± 10)min to 26(± 3)min,Moreover,the success rate vascular anastomosis increased from approximately 20% to 90%.Conclusion: Through gradual and discontinuous strengthening of microanastomosis technology training,the author has already mastered microsurgical anastomosis techniques to a certain extent that can meet preliminary clinical requirements.Part ?: Establishment of the superficial inferior epigastric artery flap in Rabbits Models and Observation of Vascular CrisisObjective: To establish the superficial inferior epigastric artery crisis flap in rabbit models and provide anatomical basis by dissecting the superficial inferior epigastric artery flap in rabbit Models.Methods: 12 rabbits were randomly numbered 1-12,anatomy group: number 1~4 rabbits were selected for vivisection;The flap model group: number 5~8 rabbits were selected and their left sides or right sides were taken as group A1: skin flap with pedicled flap of superficial inferior epigastric vessels in rabbit model;the other side was group A2: skin flap with ligated superficial inferior epigastric artery and vein of rabbit.Similarly,the remaining four rabbits were distributed into group A3: artery crisis skin flap with ligated superficial inferior epigastric artery,and their opposite sides were taken as group A4: venous crisis flap with ligated superficial inferior epigastric vein,then we observed different changes in these skin flap models.Results: The anatomy position of superficial inferior epigastric veins and arteries of rabbit(1.5-2.0kg)are superficial and the vessels diameter are relatively constant;the models of superficial inferior epigastric artery with pedicled flap,superficial inferior epigastric artery with pedicle division of free flap,artery crisis flap and venous crisis flap were established successfully,and the flap color change,swelling degree,and infective and necrosis conditions were observed 7 days after operation.Conclusion: The anatomy position of superficial inferior epigastric artery and vein of rabbits are relatively constant and superficial,which is suitable for the microsurgical technique training and establishment of superficial inferior epigastric artery flap in rabbit models.By establishing the models of superficial inferior epigastric artery with pedicled flap,superficial inferior epigastric artery with pedicle division of skin flap and crisis skin flap of artery and vein,the different changes of each group of skin flap models after operation were observed,which contribute to further experimental researches.Part ?: Experimental Study on the Superficial Inferior Epigastric Arteryial Free Flap Anastomosis in Rabbit Models by Intravascular Stent of Artificial Small Vascular BridgingObjective: To explore the new methods and applications of artificial small vessels as temporary stents in small vessels(vessels diameter<0.8mm)by the comparative experimental study between Teflon artificial small vascular bridging and traditional simply anastomosis.Methods: 24 rabbits were randomly numbered 1-24,all the rabbits were randomly distributed into experimental group or control group.No.1-12 were divided into Group B,and experimental group B1 was superficial inferior epigastric artery of rabbit by intravascular stent of artificial small vascular bridging and anastomosis,the control group B2 of the other side was treated with traditional anastomosis;number 13-24 were distributedinto group C,group C1 was superficial inferior epigastric vein of rabbit by intravascular stent of artificial small vascular bridging,the control group C2 of the other side was treated with traditional anastomosis.The anastomosis time,thedirect patency rate of the anastomotic stoma,the patency rate and the survival rate of flap transplantation of different groups were compared.Results: The mean anastomosis time of the four groups(the artificial vascular stent bridging and anastomosis vein group,the traditional simple anastomosis vein group,the artificial vascular stent bridging and anastomosis artery group and the traditional simple anastomosis artery group)showed significant differences(21±2min,27±2min,18±2min and 36±6min,respectively).The immediate or long-term patency rate of the artificial vascular stent bridging and anastomosis vein group was significantly higher than that of the traditional simple anastomosis vein group,while the artificial vascular stent bridging and anastomosis artery group and the traditional simple anastomosis artery group showed no significant difference.Conclusion: The anastomosis time,immediate patency rate,long-term patency rate and the survival rate of the flap of the intravascular stent of artificial blood vessel bridging and anastomosis has obvious advantage over traditional anastomosis(blood vessel diameter < 0.8mm),especially for venous anastomosis;the further research and development of intravascular stenting are expected to be widely used in the super-microsurgery field in the future.