Intracuticular versus subcuticular.
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Biomedical subjects
Publications and source records attributed to J J Petry.
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In order to explain the variability noted in the fluorescein staining characteristics of the epigastric axial flap in the experimental laboratory rat, the anatomy of the blood supply of this particular flap was investigated. In 10 rats, the vascular pattern of the superficial epigastric trunk to the abdominal skin was found to be similar. A small branch of the trunk extended toward the medial abdominal skin to collateralize with a branch of the internal mammary vessel entering from the chest skin. A large extension of the superficial epigastric trunk extended laterally toward the midlateral point of the animal and cephalad to collateralize with the vessels in the lateral chest wall, presumably the lateral thoracic artery. Fluorescein staining characteristics of 10 flaps including or excluding the lateral branch were examined, and a significant difference was found in the immediate fluorescein staining characteristics. The flaps that included the lateral branch fluoresced to an average of 89.2 percent of the flap length, and those in which the lateral branch was excluded fluoresced to 68.7 percent of the flap length. The use of this flap model in experimental flap research should include a precise description of the anatomy of the particular flap used in order to ensure reproducible results.
The in vitro production of prostacyclin by vein grafts was measured using vascular rings followed by radioimmunoassay of the medium. The grafts were prepared by interposing a segment of epigastric vein in a gap in the ipsilateral femoral artery of the rat. Measurements made over a period of 1 to 42 days showed a progressive rise from venous levels (less than 0.2 ng/ml) to values close to the arterial controls (10.9 +/- 2.2 ng/ml). This deficiency of prostacyclin synthesis during the "arterialization" of the graft may account for some of the early failures which can occur in vein grafting and suggests the possibility of pharmacological intervention to improve the success rate.
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In light of recent research dealing with the proaggregatory and antiaggregatory effects of prostaglandins on the primary hemostatic event of platelet aggregation, we suggest that patency in microvascular surgery be viewed from a new perspective. The sequence of events in platelet aggregation and the effects of the products of arachidonic acid metabolism on these events are reviewed. Drugs affecting platelet aggregation are classified according to their sites of action. In particular, heparin, dextran, and aspirin are discussed in relation to new information regarding their effects on arachidonic acid metabolism. Original early experimental work and clinical reports from the literature are discussed with a view toward future directions for research in improving patency in microvascular surgery.
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