腓肠神经的交感成分及其对腓肠神经营养血管皮瓣血流动力学影响的探查

doi:10.13418/j.issn.1001-165x.2017.01.006

Abstract

Abstract:

Objective　To investigate whether the sural nerve emanates sympathetic fibers to its accompanying artery, regulating its tone, and the hemodynamic change of the proximally-based sural neurovascular flap brought about by section of the sural nerve at its origin.　Methods　In 17 rabbits, two rabbits were used as the normal control group, from which the sural neurovascular bundles were harvested without flap creation, and the other 15 rabbits were randomly divided into two groups with 15 sides of hind limbs in each group: a nerve transection group, where the sural nerve was transected at its origin after creation of the proximally-based sural neurovascular flap, and a nerve preservation group, where the sural nerve was untouched after flap creation. The latter two groups were continued to be allocated respectively to three sub-groups according to the time points, i.e., 3d, 5d and 7d after flap creation. The rabbits were executed at the corresponding time points and the sural neurovascular bundles were harvested for glyoxylic acid staining. An infrared thermal imager was used for measurement of the average temperature of the flaps within 24h after flap harvest.　Results　The intensity of green fluorescent staining within the sural nerve and around the tunica externa of the sural artery showed a synchronized gradual decline in the nerve transection group at 3d, 5d and 7d after flap harvest. Significant difference of fluorescent intensity could be detected among the groups (F=13.563, P=0.004). The fluorescent intensity of the sural neurocutaneous bundle showed no decline in the nerve preservation group at the postoperative three time points. The average temperature of the flaps in the nerve transection group was higher than that in the nerve preservation group starting from 2h after flap harvest (P<0.05).　Conclusion　The sural nerve has issued sympathetic fibers to the accompanying arteries, regulating its vascular tone. The microvascular circulation within the proximally-based sural neurocutaneous flap could improve if the sural nerve is divided at its origin, leading to possible increased flap survival.

Key words: Sympathetic fibers, Sural nerve, Flap, Infrared thermal imager, Hemodynamics

XIE Yun，ZOU Wen-xuan， FANG Fang， ZHANG Qi，YE Jun-jian，ZHUANG Yue-hong . The impact on hemodynamics of proximally-based sural neurovascular flap by different management of sural nerve[J]. Chinese Journal Of Clinical Anatomy, 2017, 35(1): 25-30.

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The impact on hemodynamics of proximally-based sural neurovascular flap by different management of sural nerve

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