Evaluation of microcirculation and wound-closing tension after undermining the skin. A study in a porcine model using laser Doppler perfusion imaging

被引:0
作者
Tønseth K.A. [1 ]
Hokland B.M. [1 ]
机构
[1] Department of Plastic Surgery, Institute for Surgical Research, Rikshospitalet University Hospital
关键词
Laser Doppler imaging; Microcirculation; Skin; Tension; Undermining;
D O I
10.1007/s00238-004-0673-3
中图分类号
学科分类号
摘要
Undermining the skin can reduce wound tension when closing skin defects and thereby can provide a potentially better microcirculation. On the other hand, undermining causes damage to blood vessels. In this study the relationship between wound tension and microcirculation in undermined wounds was evaluated. A porcine model was used and in three pigs six undermined excisions and six control excisions were done. The tension needed to close the wound was noted and the postoperative microcirculation was measured with a laser Doppler perfusion imager. Undermining the skin gave significantly reduced (p<0.05) wound-closing tension with a mean decrease of 25% (95% CI: 17-33%). The postoperative microcirculation in the undermined wound was significantly reduced (p<0.05) with a mean of 28% (95% CI: 8-46%). Undermining the skin reduced the wound-closing tension. In our model the positive effect on the microcirculation by reducing the wound-closing tension was less than the negative effect of cutting the perforating blood vessels to the skin with a net decrease in blood flow. © Springer-Verlag 2004.
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页码:295 / 297
页数:2
相关论文
共 11 条
[1]  
Aydin M.A., Mavili M.E., Examining microcirculation improves the angiosome theory in explaining the delay phenomenon in a rabbit model, J. Reconstr. Microsurg., 19, pp. 187-194, (2003)
[2]  
Barnhill R.L., Bader D.L., Ryan T.J., A study of uniaxial tension on the superficial dermal microvasculature, J. Invest. Dermatol., 82, pp. 511-514, (1984)
[3]  
Bertone A.L., Principles of wound healing, Vet. Clin. North Am. Equine. Pract., 5, pp. 449-463, (1989)
[4]  
Cox K.W., Larrabee W., A study of skin flap advancement as a function of undermining, Arch. Otolaryngol., 108, pp. 151-155, (1982)
[5]  
Hochman M., Branham G., Thomas J.R., Relative effects of intraoperative tissue expansion and undermining on wound-closing tension, Arch. Otolaryngol. Head Neck Surg., 118, pp. 1185-1187, (1992)
[6]  
Hunt T.K., Hopf H., Hussain Z., Physiology of wound healing, Adv. Skin Wound Care, 13, SUPPL. 2, pp. 6-11, (2000)
[7]  
Kerrigan C.L., Zelt R.G., Thomson J.G., Diano E., The pig as an experimental animal in plastic surgery research for the study of skin flaps, myocutaneous flaps and fasciocutaneous flaps, Lab. Anim. Sci., 36, (1986)
[8]  
Mackay D.R., Saggers G.C., Kotwal N., Manders E.K., Stretching skin: Undermining is more important than intraoperative expansion, Plast. Reconst. Surg., 86, pp. 722-730, (1990)
[9]  
Melis P., Noorlander M.L., Bos K.E., Tension decrease during skin stretching in undermined versus not undermined skin: An experimental study in piglets, Plast. Reconstr. Surg., 107, pp. 1201-1205, (2001)
[10]  
Melis P., Noorlander M.L., van der Kleij A.J., van Noorden C.J., van der Horst C.M., Oxygenation and microcirculation during skin stretching in undermined and nonundermined skin, Plast. Reconstr. Surg., 112, pp. 1295-1301, (2003)