백서의 대망을 혈관경으로 이식하여 생성시킨 2차적 도서형 피판

Abstract

[한글]

미세 혈관수술의 눈부신 발전으로 보다 다양하고 복합적인 조직이식이 가능하게 되었으나 공여부로써의 유리피판은 반드시 축혈관(axial vessel)을 포함하여야 하므로 신체에서 그 공여부위는 한정되어 있다. 최근 이러한 한계를 극복하고 그 영역을 확대하기 위하여 원하는 조직에 혈관경을 이식하여 재혈행화시킴으로 2차적 도서형 피판을 만들고자하는 시도들이 활발히 진행되고 있다. 본 실험에서는 백서의 우측 위대망막혈관(right gastroepiploic vessel)을 혈관경(vascular pedicle)으로 하는 4 × 2.5 cm의 대망절편을 혈관운반체(vascular carrier)로 사용, 이를 백서 복부에 작성한 8 × 2.5 cm크기의 피부판에 접목시켜 이 피판의 재혈행화를 유도, 2차적 도서형 피판의 생성을 시도하였고 이 피판의 혈행화 정도 및 생존율을 형광색소 주사, 육안적관찰, 조직학적 관찰방법에 의하여 정량적으로 측정, 분석하였다. 목표조직인 복부피판과 혈관운반체의 접목 제 7 일째 형광염색지표는 정상피부의 평균 31.4±12.3%, 생존율 80.519.6%이었으며 이중 피판과 혈관경과의 접촉면적율이 100%일 경우 생존율은 99.1%였고 접촉면적올이 75%인 경우 생존율은 72.1%로 형광염색지표와 피판생존율, 그리고 혈관정과 목표조직의 접촉면적율과 피판생존율은 비례하였다. 이차적으로 생성시킨 도서형 복합피판의 혈관경인 위대망막혈관내로의 India ink주입후의 조직학적 검사를 통해 혈관운반체인 대망과 목표조직인 복부피판 사이에 새

로운 혈관계가 연결되어 복부피판에도 새로운 혈행계가 형성되어 있음을 확인할 수 있었다. 이와 같은 연구를 통해 얇고, 적은 부피이면서도 왕성한 혈행을 가지고 있는 대망은 목표조직을 재혈행화 시키는데 유용하게 사용될 수 있으며 매우 이상적인 혈관운반체 임을 밝혔다.

The secondary island flap using omental vascular carrier in rats

Dae Hyun Lew

Department of Medical Science, The Graduate SchoolYonsei University

(Directed by Professor Kwan Chul Tark)

The omental pedicle based on right gastroepiploic vessels was designed as a new

experimental model for prefabrication (revascularization) of composite flaps in

rats, A 2.5 × 4 cm peach of omentum with right gastroepiploic vessels was

transferred under a bipedicled paniculocutaneous flap which is 2.5 × 8 cm in size.

At day 7, all four margins were divided and the flap was raised as a secondary

island flap connected only by its vascular pedicle, then the composite flap sutured

back in Place. The flap Perfusion was examined by dermatofluorometry, and flap

survival area was measured at day 12. The secondary island flap demonstrated a dye

fluorescence index(%DFI) of 31.4±12.3 and survival rate 80.579.6%, The flap

survival area was increased when %DFI and contact surface between vascular carrier

and skin flap were increased. An india ink injection and histologic examination

provided visual evidence of revasculization of the composite flap through the

omental pedicle. The oriental pedicle is a promising and safe model for

revasculirization of other tissues.

[영문]

The omental pedicle based on right gastroepiploic vessels was designed as a new experimental model for prefabrication (revascularization) of composite flaps in rats, A 2.5 × 4 cm peach of omentum with right gastroepiploic vessels was transferred under a bipedicled paniculocutaneous flap which is 2.5 × 8 cm in size.

At day 7, all four margins were divided and the flap was raised as a secondary island flap connected only by its vascular pedicle, then the composite flap sutured back in Place. The flap Perfusion was examined by dermatofluorometry, and flap survival area was measured at day 12. The secondary island flap demonstrated a dye fluorescence index(%DFI) of 31.4±12.3 and survival rate 80.579.6%, The flap survival area was increased when %DFI and contact surface between vascular carrier and skin flap were increased. An india ink injection and histologic examination provided visual evidence of revasculization of the composite flap through the omental pedicle. The oriental pedicle is a promising and safe model for revasculirization of other tissues.