PDF(Pubmed)
Abstract：
BACKGROUND: This controlled experimental study aimed to compare ectopic replantation with other replantation techniques in a rat model of crush amputations. It also assessed the impact of different replantation methods on the viability of amputates.
METHODS: Forty male Wistar albino rats were divided into four groups. Groin flaps served as the amputation model. Group 1 un-derwent guillotine-style amputation followed by orthotopic replantation, Group 2 experienced crush-type amputation and orthotopic replantation, Group 3 had crush-type amputation and orthotopic replantation with a vein graft, and Group 4 underwent crush-type amputation followed by ectopic replantation. Flap viability and perfusion rates were assessed on day 3 using an infrared perfusion as-sessment system. The ratio of viable area to total flap area and thrombus formation in the pedicle vessels were evaluated on day 7.
RESULTS: Infrared evaluations on day 3 post-replantation revealed flap perfusion percentages of 73.5% in Group 1, 11.1% in Group 2, 65% in Group 3, and 64.1% in Group 4. Statistical analysis indicated that Group 1 exhibited the highest perfusion rates, while Group 2 showed the lowest. No differences were observed between Groups 3 and 4. On the seventh day, the average surviving flap areas were found to be 74.6% in Group 1, 2.5% in Group 2, 64.5% in Group 3, and 64% in Group 4. Statistically, Group 1 exhibited the best outcomes, while Group 2 had the poorest, with no differences between Groups 3 and 4. Additionally, thrombus formation was observed in the vessels of two animals in Group 1, nine in Group 2, and three each in Groups 3 and 4. Significant statistical differences were noted among the groups.
CONCLUSIONS: The results indicate that ectopic replantation and replantation with a vein graft are equally effective. The preferred method for crush-type replantations may depend on the patient\'s and the amputated limb\'s conditions. In crush-type amputations, we recommend vein graft repair if the patient\'s overall condition supports replantation and if crushed segments can be debrided without excessive shortening of the amputated part. If these conditions are not met, temporary ectopic replantation is advised to preserve the amputated limb.
METHODS: Forty male Wistar albino rats were divided into four groups. Groin flaps served as the amputation model. Group 1 un-derwent guillotine-style amputation followed by orthotopic replantation, Group 2 experienced crush-type amputation and orthotopic replantation, Group 3 had crush-type amputation and orthotopic replantation with a vein graft, and Group 4 underwent crush-type amputation followed by ectopic replantation. Flap viability and perfusion rates were assessed on day 3 using an infrared perfusion as-sessment system. The ratio of viable area to total flap area and thrombus formation in the pedicle vessels were evaluated on day 7.
RESULTS: Infrared evaluations on day 3 post-replantation revealed flap perfusion percentages of 73.5% in Group 1, 11.1% in Group 2, 65% in Group 3, and 64.1% in Group 4. Statistical analysis indicated that Group 1 exhibited the highest perfusion rates, while Group 2 showed the lowest. No differences were observed between Groups 3 and 4. On the seventh day, the average surviving flap areas were found to be 74.6% in Group 1, 2.5% in Group 2, 64.5% in Group 3, and 64% in Group 4. Statistically, Group 1 exhibited the best outcomes, while Group 2 had the poorest, with no differences between Groups 3 and 4. Additionally, thrombus formation was observed in the vessels of two animals in Group 1, nine in Group 2, and three each in Groups 3 and 4. Significant statistical differences were noted among the groups.
CONCLUSIONS: The results indicate that ectopic replantation and replantation with a vein graft are equally effective. The preferred method for crush-type replantations may depend on the patient\'s and the amputated limb\'s conditions. In crush-type amputations, we recommend vein graft repair if the patient\'s overall condition supports replantation and if crushed segments can be debrided without excessive shortening of the amputated part. If these conditions are not met, temporary ectopic replantation is advised to preserve the amputated limb.
摘要：
背景：这项对照实验研究旨在比较挤压截肢大鼠模型中的异位再植与其他再植技术。它还评估了不同的再植方法对截肢物的活力的影响。
方法：40只雄性Wistar白化病大鼠分为4组。腹股沟皮瓣用作截肢模型。第一组未断头台式截肢，然后进行原位再植，第2组经历了挤压式截肢和原位再植，第3组进行了挤压式截肢和静脉移植物原位再植，第4组进行挤压式截肢，然后进行异位再植。在第3天使用红外灌注作为评估系统评估皮瓣活力和灌注速率。在第7天评估了存活面积与总皮瓣面积的比率以及椎弓根血管中的血栓形成。
结果：再植后第3天的红外评估显示，第1组皮瓣灌注百分比为73.5％，第2组为11.1％，第3组为65％，第4组为64.1％。统计分析表明，第1组表现出最高的灌注率，而第2组显示最低。在第3组和第4组之间没有观察到差异。第七天，发现第1组平均存活皮瓣面积为74.6%,第2组为2.5%,第3组为64.5%,第4组为64%.统计上,第一组表现出最好的结果，而第二组最贫穷的人，第3组和第4组之间没有差异。此外,在第1组2只动物的血管中观察到血栓形成,第2组9只,第3组和第4组各3只.观察到各组之间的显著统计学差异。
结论：结果表明，异位再植和静脉移植再植同样有效。挤压型再植的优选方法可能取决于患者和截肢肢体的状况。在挤压式截肢中，如果患者的整体状况支持再植，并且如果破碎的节段可以清创而不会过度缩短截肢部分，我们建议进行静脉移植修复。如果不满足这些条件，建议临时异位再植以保留截肢的肢体。
方法：40只雄性Wistar白化病大鼠分为4组。腹股沟皮瓣用作截肢模型。第一组未断头台式截肢，然后进行原位再植，第2组经历了挤压式截肢和原位再植，第3组进行了挤压式截肢和静脉移植物原位再植，第4组进行挤压式截肢，然后进行异位再植。在第3天使用红外灌注作为评估系统评估皮瓣活力和灌注速率。在第7天评估了存活面积与总皮瓣面积的比率以及椎弓根血管中的血栓形成。
结果：再植后第3天的红外评估显示，第1组皮瓣灌注百分比为73.5％，第2组为11.1％，第3组为65％，第4组为64.1％。统计分析表明，第1组表现出最高的灌注率，而第2组显示最低。在第3组和第4组之间没有观察到差异。第七天，发现第1组平均存活皮瓣面积为74.6%,第2组为2.5%,第3组为64.5%,第4组为64%.统计上,第一组表现出最好的结果，而第二组最贫穷的人，第3组和第4组之间没有差异。此外,在第1组2只动物的血管中观察到血栓形成,第2组9只,第3组和第4组各3只.观察到各组之间的显著统计学差异。
结论：结果表明，异位再植和静脉移植再植同样有效。挤压型再植的优选方法可能取决于患者和截肢肢体的状况。在挤压式截肢中，如果患者的整体状况支持再植，并且如果破碎的节段可以清创而不会过度缩短截肢部分，我们建议进行静脉移植修复。如果不满足这些条件，建议临时异位再植以保留截肢的肢体。
