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Objective To investigate the anatomy characteristics of saphenous artery(SA) and its perforator vessels in mini pig,and to provide a new perforator flap animal model.Methods Between May,2018 and August,2018,6 7-months-old mini pigs weight 25 kilograms were sacrificed by blooding under general anesthesia.The bilateral external iliac arteries were injected with a mixture of latex-lead oxide mixture and underwent CT-scanning to provide 3-dimensional reconstruction.The origin,diameter,courses and distribution of the SA and perforators of both hind limbs were observed.Results One of the hind limbs was abandoned due to the leakage of perfusion fluid.The other 11 hind limbs were available.The femoral artery passed through the medial femoral muscle and sartorius muscle in the middle of thigh,and run between the medial femoral muscle and gracilis muscle above the knee.Below the knee,it run on the surface of the medial leg muscles.A number of small branches were distributed in the tarsal joint and calcaneus at the medial malleolus,and there were abundant communicating branches with the posterior tibial artery.The average length of SA was (14.86±0.76) mm.The outer diameters of SA at initiative,medial tibial condyle and medial malleolus were(1.73±0.15) mm,(1.50±0.12) mm and (1.30±0.13) mm,respectively.There were a total of 79 perforators which were identified,with a mean of (7.09±1.16) perforators per hind limbs.And the average outer diameter was 0.10-0.78 (0.40±0.13) mm.Conclusion The SA constantly exist with good outer diameter.The number of perforator is abundant.SA can be used as a reliable animal model for studying and training of perforator flap.
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Objective To investigate the effect of retrograde sartorius myocutaneous flap for reparing skin defects of leg.Methods In the anatomic study,50 cadaveric lower limb were injected with red latex and the origin,diameter,course,distribution and anastomosis of sartorius's arteries were observed.Arteriographies were made in 4 sides of fresh specimens to study the arterial anastomosis in sartorius.Based on anatomic research results,we designed the retrograde sartorius myocutaneous flap for reparing skin defects of leg.Results Nutrient arteries of sartorius represented segnental distribution,Link-pattern arterial anastomosises were formed in sartorius by branches of adjacent vascular pedicles.Cutaneous arteries and musculocutaneous arteries above deep fascia formed interlocking arterial anastomosises net which provided blood supply for the skin on sartorius.The arterial branches in the distal 2/5 of sartorius came from saphenous artery,composed an arterial network around knee joint,which consist of anatomic basis for the blood supply of retrograde sartorius myocutaneous flap.Form February,2010 to April,2014,the retrograde sartorius myocutaneous flap were used to repair skin defects of leg in 2 cases.The flap size ranged from 7 cn×18 cm to 12 cm×25 cm.All flaps survived successfully with no ulcer.2 cases were followed up for 7 to 16 months.The skin color and texture were satisfactory.Conclusion the retrograde sartorius myocutaneous flap has constantly,reliable blood supply,and easily performed.It is an effective method for the reconstruction skin defects of leg.
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Objective To evaluate the feasibility of interventional catheterization via saphenous artery route in treating hepatic and renal lesions, to compare its advantages and disadvantages with trans-femoral approach catheterization, and to discuss the feasibility of using saphenous artery route to replace femoral artery approach.Methods A total of 24 rabbits bearing VX2 liver and kidney tumor were randomly divided into via femoral artery catheterization group (control group,n=8) and via saphenous artery catheterization group (study group,n=16). Surface distribution and variation of saphenous artery were recorded. After the saphenous artery was isolated, blood vessel was punctured with a 22 G needle, through which a 0.018 inch micro guide wire together with a 5-F micro catheter sheath was inserted into the artery, then, a Y-valve was connected to the sheath. DSA was performed to determine the diameters of the saphenous artery, femoral artery and iliac artery. The used time for isolating the artery and indwelling the sheath, the depth of sheath insertion, the success rate of catheterization, the incision infection rate and the occurrence of claudication in both groups were recorded, and the results were compared. Results Saphenous artery could be clearly observed on body surface in 91.67%of rabbits (22/24). Successful insertion of catheter sheath was achieved in all rabbits of both groups. The used time of isolating artery, the depth of sheath insertion, the incision infection rate and the occurrence of claudication at 7 and 14 days after the treatment in the study group were(367.30±37.30) seconds, (20.20±2.60) mm, 0%, 6.25%and 0%respectively, while those in the control group were (978.20±156.30) seconds,(58.60±9.50) mm, 37.50%, 62.50% and 25% respectively. The differences in above mentioned measurement items between the two groups were statistically significant (P0.05). The diameters of the saphenous artery, superficial femoral artery, common femoral artery, external iliac artery and common iliac artery were (1.29±0.12) mm,(1.91±0.27) mm, (2.18±0.15) mm, (2.22±0.13) mm and(2.39± 0.15) mm respectively. Conclusion In rabbits, the saphenous artery is usually superficially located, its anatomical variation rate is very low, and its internal diameter can match 5- F micro catheter sheath. Catheterization via saphenous artery is convenient, time-saving with less damage and fewer complications. Therefore, in treating hepatic and renal lesions in rabbits the catheterization via saphenous artery can be used as the technique of first choice to replace the femoral approach catheterization.
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Objective To evaluate the surgical technique and clinical significance of the therapy for ankle soft tissue defect with 2 different flee perforator flaps.Methods Twenty-five cases of ankle soft tissue defect with exposed bone of the ankle were involved in this study from August 2006 to April 2012.and the wound sizes varied from 4.0 cm × 5.5 cm to 11.0 cm × 23.0 cm.Twenty cases with acrotarsium soft tissue defect were repaired by free anterolateral thigh perforator flap,five cases with pelma soft tissue defect were repaired by free saphenous artery perforator flap.Results All Twenty-five flaps survived.At 3 to 50 months follow-up [on an average of (18.0 ± 0.8) months] postoperatively,appearance of the flaps was satisfactory,with 10 to 22 mm in 2-PD,and the sensation percentage beyond S2+ was 13/20 cases and 5/5 cases at 3 months follow-up,respectively.Conclusion The optimal therapy for the acrotarsium soft tissue defect is the free perforator anterolateral thigh flap,and free saphenous artery perforator flap should be used for pelma soft tissue defect.Avoid secondary orthopaedic surgery,pay more attention to the donor site of the flap.VSD can significantly promoting the survival rates of the free perforator flaps if the soft defects are caused by open injury.
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Aim To establish a model of biphasic vasoconstriction induced by electrical stimulation, and analyze effects of 1～100 nmol?L~(-1) tetrodotoxin (TTX) on the biphasic vasoconstriction in the ring preparation of the rabbit saphenous artery. Methods Isometric vasoconstriction of the rabbit saphenous arterial rings was recorded, and the sympathetic nerves of the arterial rings were activated with electrical stimulation. Results The biphasic neurogenic vasoconstriction was consistently induced by electrical stimulation (15 V,1 ms pulse duration,2～16 Hz for 32 s) in a frequency-related manner in the rabbit saphenous artery. TTX (3 nmol?L~(-1)),a neuronally selective sodium channel blocker,did not affect the first phase of vasoconstriction,but it markedly inhibited the second phase of vasoconstrictive responses to 2～16 Hz stimulation by 44 %～67 %. Increasing the concentration of TTX to 10 nmol?L~(-1), TTX inhibited the first phase of the vasocontractive responses to 4～16 Hz stimulation by 40%～57%,whereas it inhibited more than 90% of the second phase of vasoconstriction. Concentration-response curves for NA(0.01～30 ?mol?L~(-1)) were not affected by TTX (0.1 ?mol?L~(-1)), but the same concentration of TTX completely inhibited the biphasic vascular responses to electrical stimulation. The biphasic contractile responses to electrical stimulation were all abolished by guanethidine (10 ?mol?L~(-1)), but the vasoconstrictive responses to exogenous NA were not affected by it. Conclusion Biphasic vasoconstriction can be induced by electrical stimulation,and the first and the second phases of vasoconstriction are mediated by neurotransmitters released from sympathetic nerves in the rabbit isolated saphenous arterial ring preparation.
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0.05). Conclusions Ultrasonography is an objective, accurate, non-invasive and utility method to evaluate the saphenous artery of saphenous skin flap before operation.