RESUMEN
It has been known that the improved drainage of a flap increases its survival and the increasing number of draining vein improves survival of flaps. But recently, researches have proved that the different orientation of venous outflow on the island flap is more important than the number of outflow tracts. The purpose of this study is to investgate the survival rates of flaps with various numbers or locations of draining veins. An 6 X 7cm flap was raised on the abdomen of 40 white rats (Sprague-Dowley, 350 - 400 gm). Rats were divided into 4 groups and each group consisted of 10 rats. In group 1 (A l$ flaps were based on the inferior epigastric artery and vein on the ipsilateral side. In group 2 (A-V), flaps were based on the inferior epigastric artery on the ipsilateral side and the inferior epigastric vein on the contralateral side. In group 3 (AV-V), flaps were based on the inferior epigastric artery and vein on the ipsilateral side and the inferior epigastric vein on the contralateral side. In group 4 (Av-V), flaps were based on the inferior epigastric artery and lateral thoracoepigastric vein on the ipsilateral side and the inferior epigastric vein on the contralateral side. A definite assessment was made on the seventh day after flap elevation. The necrotic areas of flaps were determined with Computer Image Analysis System and barum-sulfate microangiographys were performed The necrotic area was 38.14% in group 1, 18.73% in group 2, 33.53% in group 3, and 31.94% in group 4 respectively. The microangiographs showed striking digerences in the vascular pattern in the flaps, and numerous collaterals and dilated anastomotic vessels were observed in group 2. These data indicate that the location of draining vein is more important than the number, and proper location of the draining vein allows the recruitment of an adjacent angiosome and can improve the survival rates of island flap.
Asunto(s)
Animales , Ratas , Abdomen , Drenaje , Arterias Epigástricas , Huelga de Empleados , Colgajos Quirúrgicos , Tasa de Supervivencia , VenasRESUMEN
The incidence of nasal bone fracture in children is relatively uncommon compared with that in adults. But nasal injuries in children merit special attention, because the disturbance of the growth centers essential to the normal development may cause significant cosmetic or functional disabilities, the patients should be carefully examined and properly treated. Because the injured nose swells more quickly and more diffusely in children than in adults, the diagnosis is more difficult. The pediatric patient does not permit even the most gentle examination at times and x-ray examination is often inconclusive. Because of these reasons, the diagnosis of nasal fractures in children is often difficult. The authors have performed facial bone CT in accurate diagnosis of the nasal bones fractures in such children. Conclusively, facial bone CT is useful in early accurate evaluation of the nasal bones fractures in children.
Asunto(s)
Adulto , Niño , Humanos , Diagnóstico , Huesos Faciales , Incidencia , Hueso Nasal , NarizRESUMEN
There are some attempts to improve the survival of venous island flap, such as delay procedure and pharmacological agents. This study includes prefabrication of vein which could enhance the survival of the venous island flap. The venous island flap was created by a branch of the central vein in rabbit auricle. At 1.5 cm away from the distal margin of the designed flap, the central vein was dissected and transferred under the random part of the future venous flap for 1 week. The survival of prefabricated venous flap was compared with unprefabricated flap 1 week after the flap elevation. The vasculature in the flap were also visualized by microfil cast. The results were as follows: 1. The prefabrication improved the survival of the venous flap significantly. 2. The transferred veins in the prefabricated flap were well visualized 1 week after the flap elevation. In conclusion, it is inferred that the prefabrication enhance the survival of the venous island flap.
Asunto(s)
Elastómeros de Silicona , VenasRESUMEN
Venous island flap has many advantages over other flaps, such as random pattern flap, island flap or free flap. It can cover the defect with wide arc of rotation and does not require vessel anastomosis and arterial pedicle, hence more sites are available for donor. The procedure is a time saving and simple procedure and can be performed even by two operating members. But it is not frequently used because of the poor survival of the flap. In this study, we attempted to allow whether pharmacological or delay procedure can enhance the survival of the venous island flap and the mechanism of the delay flap survival. We devised a model of venous island flap whose pedicle was a branch of central vein on the auricle of Newzeland white rabbit. SOD, allopurinol and SOD and allopurinol were given as pharmacological treatment and delay procedure was carried out to enhance the survival of the flap. For the study of survival mechanism of the delay flap, SOD levels of the delay and non-delay flap were observed by SOD 525 method. The results were as follows: 1. Allopurinol, SOD and, SOD and allopurinol improved the survival of the flap significantly. 2. Delay procedure improved the survival of the flap significantly. 3. The level of SOD in delay flap was higher than that of non-delay flap regardless of the site within the flap or time passage. In conclusion, it is inferred that the administration of allopurinol and SOD and surgical delay can enhance the survival of the venous island flap. In delay venous island flap, increased level of SOD within the flap seem to contribute to the increased survival of the flap.