下腹部超回流皮瓣的血流动力学研究及临床应用
|
摘要
研究目的：
(一)实验研究：1、论证小型猪上腹部解剖结构以及血供特点和人类下腹部的相似性,建立与人类下腹部皮瓣血供模式相类似的动物模型；2、比较皮瓣模型在不同超回流状态下的血流动力学特点,阐明静脉超回流促进皮瓣成活的作用及其机制。
(二)临床应用：评价腹部超回流皮瓣的应用价值。
研究方法：
1、选取雌性Yorkshire小型猪两只。应用MDCT血管造影及尸体解剖对小型猪腹部解剖结构进行研究,记录腹壁上下血管的走行以及管径等基本信息,和人类腹部特点进行对比。
2、选取雌性Yorkshire小型猪4只。(1)于小型猪上腹部形成游离TRAM皮瓣,以激光多普勒血流灌注成像仪测量皮瓣血流灌注,并将其血供特点和人类下腹部皮瓣进行对比；(2)术后七天测量小型猪腹部皮瓣成活面积,统计皮瓣局部坏死的发生率,以及皮瓣成活面积百分比。
3、选取雌性Yorkshire小型猪8只。(1)于小型猪上腹部形成三种不同的超回流皮瓣模型。测量一系列血流动力学指标,并进行对比；(2)将八只动物随机分为两组,一组保留对侧腹壁浅静脉,一组保留同侧腹壁浅静脉。术后七天处死动物并测量其腹部皮瓣成活面积。
4、将6例采用静脉超回流DIEP皮瓣的临床病例与同时期的38例单蒂DIEP皮瓣的病例进行对比。比较手术时间,皮瓣并发症发生率以及腹部并发症发生率等指标。
结果：
1、小型猪上腹部解剖层次和血管分布规律与人类下腹部相似。不同的是其腹壁上血管为优势血管,腹壁下血管较细,两者差别明显。
2、小型猪上腹部皮瓣的血供特点
(1)小型猪上腹部皮瓣Ⅰ区至Ⅳ区平均血流灌注量分别为：197.0±24.2、138.8±25.4、103.2±36.4、30.2±11.8。统计学差异显著(P=0.00)。
(2)皮瓣部分坏死发生率100%,各实验动物的皮瓣面积百分比分别为：85.2%,76.1%,91.4%,75.7%,均值为(82.1±7.6)%。
3、以无超回流情况为参照,在同侧腹壁浅静脉(ISSEV)、对侧腹壁浅静脉(CSSEV)以及对侧腹壁上静脉(CDSEV)三种不同的超回流模式下,皮瓣两侧静脉压均明显降低,Ⅳ区血流灌注量增加,PH值和PO2升高,皮瓣成活面积增加。
4、6例采用静脉超回流技术的病例皮瓣并发症和腹部并发症均为0,平均手术时间为(8.3±0.8)h,和DIEP相比均无统计学差异。
结论：
1、小型猪有着和人类相似的腹部解剖结构,血管构筑也和人类相对应。
2、小型猪上腹部的血供特点和人类下腹部相近,可以按照人下腹部皮瓣的分区方式进行划分,该皮瓣模型远端可以产生稳定坏死。是模拟人类下腹部皮瓣良好的实验动物模型。
3、静脉超回流技术对于扩大皮瓣的成活面积切实有效。超回流静脉通过降低皮瓣远端的静脉压力进而减少毛细血管后阻力,改善皮瓣远端的静脉淤血和代谢不良,增加皮瓣远端血供,扩大皮瓣成活范围。
4、静脉超回流技术可以显著改善皮瓣远端的血液供应,降低皮瓣并发症的发生率。且不会加大对腹部供区的损伤。
Objectives
(一) Experimental studies:1. To testify the similarity of the anatomy and blood perfusion in abdominal flaps between pig and mankind; 2. Clarify the efficacy and mechanism of venous superdrainage via the comparison of hemodynamics in different modes.
(二) Clinical applications:To evaluate the efficacy of super-drained abdominal flap.
Methods
1. Two female Yorkshire micropigs were included. Both of them received MDCT angiography and then, one of them was sacrificed after euthanasia, the basic information of vessels such as the course and diameters were recorded and compared with that of human.
2. Four female Yorkshire micropigs were selected for the study of the flap physiologies. (1) Blood perfusion was scanned by a perfusion imaging system after flap formation, after that the results were compared with the lower abdominal flap of human;(2) Measure the survival area of the flaps 7 days postoperation, calculate the flap necrotic rate and survival rate.
3. Another similar 8 pigs were included. (1) Form three different kinds of venous superdrainage modes in a Free-TRAM flap model, then compare several hemodynamic indexes among them; (2) Divide the 8 animals into 2 groups. One group was super-drained by CSSEV, the other with ISSEV. The animals were sacrificed in the 7th postoperative day, and the final partial necrosis rate and the survival rate were compared to the control group.
4.6 clinical cases with superdrainage techniques were compared to the 38 cases who underwent DIEP flaps in the same period, the operation time, flap complication rate and abdominal complication rate were calculated for significance analysis.
Results
1. The anatomy of pig abdomen and the vascular structures are similar to that of humans. But there is an opposite condition to human, for the deep superior epigastric vessels in pigs are superior to the inferior ones, and the diameter of the two groups varies obviously. The superficial vein exists constantly, but the superficial artery was always absent. The linea Alba is much like the humans, it is positioned in the middle of the abdomen, the structure is stiff and lack of vessels.
2. (1) The average perfusion unit from zone I to zone IV was 197.0±24.2、138.8±25.4、103.2±36.4、30.2±11.8. There was statistical significance using ANOVA analysis.
(2) The flap necrosis rate was 100%, while the survival area percentage was 85.2%,76.1%,91.4%,75.7% respectively, the mean survival area percentage was (82.1±7.6)%.
3. Compared to the condition in none superdrainage, the blood perfusion of zone IV was increased obviously while the PH value and PO2 were elevated, the survival area percentage was increased under the three superdrainage conditions.
4. The flap complication and the abdominal complication rate were 0 in the superdrainage group. While the operation time in this group was (8.3±0.8) h, there was no statistical significance between this group and the control group.
Conclusions
1. The abdominal anatomy and the blood vasculature of micropig are similar to that of humans.
2. The specificity of the blood supply in the pig's abdomen was similar to that of human. It also has a consistent necrosis area. It is really a good flap model to human lower abdomen.
3. The superdrainage technique is effective to elevate the viability of the distal part of flap. It can promote the blood perfusion of flap by lower down the postcapillary force. Based on the study, the efficacy comparison should be:CDSEV>CSSEV>ISSEV.
4. Superdrainage technique can improve the blood supply to the distal portion of the abdominal flap, so as to elevate the viability and lower the flap complication rate. Besides, it would not add destroy to the donor site.
(一)实验研究：1、论证小型猪上腹部解剖结构以及血供特点和人类下腹部的相似性,建立与人类下腹部皮瓣血供模式相类似的动物模型；2、比较皮瓣模型在不同超回流状态下的血流动力学特点,阐明静脉超回流促进皮瓣成活的作用及其机制。
(二)临床应用：评价腹部超回流皮瓣的应用价值。
研究方法：
1、选取雌性Yorkshire小型猪两只。应用MDCT血管造影及尸体解剖对小型猪腹部解剖结构进行研究,记录腹壁上下血管的走行以及管径等基本信息,和人类腹部特点进行对比。
2、选取雌性Yorkshire小型猪4只。(1)于小型猪上腹部形成游离TRAM皮瓣,以激光多普勒血流灌注成像仪测量皮瓣血流灌注,并将其血供特点和人类下腹部皮瓣进行对比；(2)术后七天测量小型猪腹部皮瓣成活面积,统计皮瓣局部坏死的发生率,以及皮瓣成活面积百分比。
3、选取雌性Yorkshire小型猪8只。(1)于小型猪上腹部形成三种不同的超回流皮瓣模型。测量一系列血流动力学指标,并进行对比；(2)将八只动物随机分为两组,一组保留对侧腹壁浅静脉,一组保留同侧腹壁浅静脉。术后七天处死动物并测量其腹部皮瓣成活面积。
4、将6例采用静脉超回流DIEP皮瓣的临床病例与同时期的38例单蒂DIEP皮瓣的病例进行对比。比较手术时间,皮瓣并发症发生率以及腹部并发症发生率等指标。
结果：
1、小型猪上腹部解剖层次和血管分布规律与人类下腹部相似。不同的是其腹壁上血管为优势血管,腹壁下血管较细,两者差别明显。
2、小型猪上腹部皮瓣的血供特点
(1)小型猪上腹部皮瓣Ⅰ区至Ⅳ区平均血流灌注量分别为：197.0±24.2、138.8±25.4、103.2±36.4、30.2±11.8。统计学差异显著(P=0.00)。
(2)皮瓣部分坏死发生率100%,各实验动物的皮瓣面积百分比分别为：85.2%,76.1%,91.4%,75.7%,均值为(82.1±7.6)%。
3、以无超回流情况为参照,在同侧腹壁浅静脉(ISSEV)、对侧腹壁浅静脉(CSSEV)以及对侧腹壁上静脉(CDSEV)三种不同的超回流模式下,皮瓣两侧静脉压均明显降低,Ⅳ区血流灌注量增加,PH值和PO2升高,皮瓣成活面积增加。
4、6例采用静脉超回流技术的病例皮瓣并发症和腹部并发症均为0,平均手术时间为(8.3±0.8)h,和DIEP相比均无统计学差异。
结论：
1、小型猪有着和人类相似的腹部解剖结构,血管构筑也和人类相对应。
2、小型猪上腹部的血供特点和人类下腹部相近,可以按照人下腹部皮瓣的分区方式进行划分,该皮瓣模型远端可以产生稳定坏死。是模拟人类下腹部皮瓣良好的实验动物模型。
3、静脉超回流技术对于扩大皮瓣的成活面积切实有效。超回流静脉通过降低皮瓣远端的静脉压力进而减少毛细血管后阻力,改善皮瓣远端的静脉淤血和代谢不良,增加皮瓣远端血供,扩大皮瓣成活范围。
4、静脉超回流技术可以显著改善皮瓣远端的血液供应,降低皮瓣并发症的发生率。且不会加大对腹部供区的损伤。
Objectives
(一) Experimental studies:1. To testify the similarity of the anatomy and blood perfusion in abdominal flaps between pig and mankind; 2. Clarify the efficacy and mechanism of venous superdrainage via the comparison of hemodynamics in different modes.
(二) Clinical applications:To evaluate the efficacy of super-drained abdominal flap.
Methods
1. Two female Yorkshire micropigs were included. Both of them received MDCT angiography and then, one of them was sacrificed after euthanasia, the basic information of vessels such as the course and diameters were recorded and compared with that of human.
2. Four female Yorkshire micropigs were selected for the study of the flap physiologies. (1) Blood perfusion was scanned by a perfusion imaging system after flap formation, after that the results were compared with the lower abdominal flap of human;(2) Measure the survival area of the flaps 7 days postoperation, calculate the flap necrotic rate and survival rate.
3. Another similar 8 pigs were included. (1) Form three different kinds of venous superdrainage modes in a Free-TRAM flap model, then compare several hemodynamic indexes among them; (2) Divide the 8 animals into 2 groups. One group was super-drained by CSSEV, the other with ISSEV. The animals were sacrificed in the 7th postoperative day, and the final partial necrosis rate and the survival rate were compared to the control group.
4.6 clinical cases with superdrainage techniques were compared to the 38 cases who underwent DIEP flaps in the same period, the operation time, flap complication rate and abdominal complication rate were calculated for significance analysis.
Results
1. The anatomy of pig abdomen and the vascular structures are similar to that of humans. But there is an opposite condition to human, for the deep superior epigastric vessels in pigs are superior to the inferior ones, and the diameter of the two groups varies obviously. The superficial vein exists constantly, but the superficial artery was always absent. The linea Alba is much like the humans, it is positioned in the middle of the abdomen, the structure is stiff and lack of vessels.
2. (1) The average perfusion unit from zone I to zone IV was 197.0±24.2、138.8±25.4、103.2±36.4、30.2±11.8. There was statistical significance using ANOVA analysis.
(2) The flap necrosis rate was 100%, while the survival area percentage was 85.2%,76.1%,91.4%,75.7% respectively, the mean survival area percentage was (82.1±7.6)%.
3. Compared to the condition in none superdrainage, the blood perfusion of zone IV was increased obviously while the PH value and PO2 were elevated, the survival area percentage was increased under the three superdrainage conditions.
4. The flap complication and the abdominal complication rate were 0 in the superdrainage group. While the operation time in this group was (8.3±0.8) h, there was no statistical significance between this group and the control group.
Conclusions
1. The abdominal anatomy and the blood vasculature of micropig are similar to that of humans.
2. The specificity of the blood supply in the pig's abdomen was similar to that of human. It also has a consistent necrosis area. It is really a good flap model to human lower abdomen.
3. The superdrainage technique is effective to elevate the viability of the distal part of flap. It can promote the blood perfusion of flap by lower down the postcapillary force. Based on the study, the efficacy comparison should be:CDSEV>CSSEV>ISSEV.
4. Superdrainage technique can improve the blood supply to the distal portion of the abdominal flap, so as to elevate the viability and lower the flap complication rate. Besides, it would not add destroy to the donor site.
引文
[1]Hartrampf CR, Scheflan M, Black PW. Breast reconstruction with a transverse abdominal island flap [J]. Plast Reconstr Surg,1982,69 (2): 216-224.
[2]Hartrampf CR. Transverse abdominal island flap technique for breast reconstruction after mastectomy [M]. Baltimore:University Park Press, 1984:84.
[3]Restifo RJ, Ahmed SS, Isenberg JS, et al. Timing, magnitude, and utility of surgical delay in the TRAM flap:II. Clinical studies [J]. Plast Reconstr Surg,1997,99(5):1217-1223.
[4]Harashina T, Sone T, et al. Augmentation of circulation of pedicled transverse rectus abdominis musculocutaneous flaps by microvascular surgery [J]. Br J Plast Surg,1987,40(4):367-370.
[5]Beegle PH. Microvascular augmentation of TRAM flap circulation (Supercharged TRAM)[A]. In Hatrampf CR. Hartrampf's Breast Reconstruction with Living Tissue [M]. Norfork:Hampton Press,1991:151.
[6]Berrino P, Santi PL. Hemodyna(?)ic analysis of the TRAM. Application to the "Recharged TRAM" flap [J]. Clin Plast Surg,1994,2(2):233-245.
[7]Berrino P, Casabona F, Adami M, et al. The "TRAM" flap for autologus tissue breast reconstruction in patients with vertical midabdominal scars [J]. Ann Plast Surg,1999,43(2):119-126.
[8]Holmstrom H. The free abdominoplasty flap and its use in breast reconstruction. An experimental study and clinical case report [J]. Scand J Plast Reconstr Surg,1979,13(3):423-427.
[9]Amez ZM, Smith RW, Eder E, et al. Breast reconstruction by the free lower transverse rectus abdominis musculocutaneous flap [J]. Br J Plast Surg,1988,41(5):500-505.
[10]Grotting JC, Urist MM, Maddox WA, et al. Convebtional TRAM versus free microsurgical TRAM flap for immediate breast reconstruction [J]. Plast Reconstr Surg,1989,83(4):828-833.
[11]Koshima I, Soeda S. Inferior epigastric artery skin flaps without rectus abdominis muscle [J]. Br J Plast Surg,1989,42(7):645-648.
[12]Kroll SS. Fat necrosis in free transverse rectus abdominus myocutaneous and deep inferior epigastric perforator flaps [J]. Plast Reconstr Surg,2000,106(3):576-583.
[13]Hamdi M, Weiler-Mithoff EM, Webster MH. Deep inferior epigastric perforator flap in breast reconstruction:experience with the first 50 flaps [J]. Plast Reconstr Surg,1999,103(1):86-95.
[14]Keller A. The deep inferior epigastric perforator free flap for breast reconstruction [J]. Ann Plast Surg,2001,46(1):474-479.
[15]Nahabedian MY, Momen B, Galdino G, et al. Breast reconstruction with the free TRAM or DIEP flap:patient selection, choice of flap, and outcome [J]. Plast Reconstr Surg,2002,110(2):466-475.
[16]Allen RJ, Treece P. Deep inferior epigastric perforator flap for breast reconstruction [J]. Ann Plast Surg,1994,32(1):32-38.
[17]Taylor GI, Daniel RK. The anatomy of several free flap donor sites [J]. Plast Reconstr Surg,1975,56(3):243-253.
[18]Grotting JC. The free abdominoplasty flap for immediate breast reconstruction [J]. Ann Plast Surg,1991,27(4):351-354.
[19]Taylor GI. An anatomical study of the venous drainage of the transverse rectus abdominis musculocutaneous flap (discussion) [J]. Plast Reconstr Surg,1987,79(2):216-217.
[20]Hartrampf CR, Bennett GK. Autologus tissue reconstruction in the mastectomy patient:clinical review of 300 patients [J]. Ann Surg,1987, 205(5):508-519.
[21]Wagner DS, Michelow BJ, Hartrampf CR. Double-pedicled TRAM flap for unilateral breast reconstruction [J]. Plast Reconstr Surg,1999,88(6): 987-997.
[22]Kroll SS, Marchi M. Comparison of strategies for preventing abdominal-wall weakness after TRAM flap breast reconstruction [J]. Plast Reconstr Surg,1992,89(6):1045-1051.
[23]Beastly ME. The pedicled TRAM as preference for immediate autogeneous tissue breast reconstruction [J]. Clin Plast Surg,1994,21(2):191-205.
[24]Watterson PA, Bostwick J III, Hester TR, Bried JT, et al. TRAM flap anatomy correlated with a 10-year clinical experience with 556 patients [J]. Plast Reconstr Surg,1995,95(7):1185-1194.
[25]Clugston PA, Gingrass MK, Azurin D, et al. Ipsilateral pedicled TRAM flaps:the safer alternative [J]? Plast reconstr Plast,2000,105(1): 77-82.
[26]Paige KT, Bostwick J III, Bried JT, et al. A comparison of morbidity from bilateral, unipedicled and unilateral, unipedicled TRAM flap breast reconstructions [J]. Plast Reconstr Surg,1998,10(7):1819-1827.
[27]Kroll SS, Coffey JA, Winning RJ, et al. An comparison of factors affecting aesthetic outcomes of TRAM flap breast reconstructions [J]. Plast Reconstr Surg,1995,96(4):860-864.
[28]Grotting JC, Urist MM, Maddox WA, et al. Conventional TRAM versus free microsurgical TRAM flap for immediate breast reconstruction [J]. Plast Reconstr Surg,1989,83(4):828-833.
[29]Serletti JM, Moran SL. Free versus the pedicled TRAM flap:a cost comparison and outcome analysis [J]. Plast Reconstr Surg,1997,100(6): 1418-1424.
[30]Moran SL, Serletti JM. Outcome comparison between free and pedicled TRAM flap breast reconstruction in the obese patient [J]. Plast Reconstr Surg,2001,108(7):1954-1960.
[31]Emi D, Harder YD. The dissection of the rectus abdominis myocutaneous flap with complete preservation of the anterior rectus sheath [J]. Br Assoc Plast Surg,2003,56(4):395-400.
[32]Suominen S, Asko-Seljavaara S, von Smitten K, et al. Sequelae in the abdominal wall after pedicled or free TRAM flap surgery [J]. Ann Plast Surg,1996,36(6):629-636.
[33]Elliott LF, Eskenazi L, Beegle PH, et al. Immediate TRAM flap breast reconstruction:128 consecutive cases [J]. Plast Reconstr Surg,1993, 92(2):217-227.
[34]Schusterman MA, Kroll SS, Weldom ME. Immediate breast reconstruction: Why the free TRAM over the conventional TRAM flap [J]? Plast Reconstr Plast, 1992,90(2):255-261.
[35]Gherardini G, Amander C, Gylbert L, et al. Pedicles compared with free transverse rectus abdominis myocutaneous flaps in breast reconstruction [J]. Scand J Plast Reconstr Surg Hand Surg,1994,28(1): 69-73.
[36]Baldwin BJ, Schusterman MA, Miller MJ, et al. Bilateral breast reconstruction:conventional versus free TRAM [J]. Plast Reconstr Surg, 1994,93(7):1410-1416.
[37]Suominen S, Tervahartiala P, von Smitten K, et al. Megnetic resonance imaging of the TRAM flap donor site [J]. Ann Plast Surg,1997,38(1):23-28.
[38]Duchateau J, Declety A, Lejour M. Innervation of the rectus abdominis muscle:implications for rectus flaps [J]. Plast Reconstr Surg,1988,82(2): 223-227.
[39]Hammond DC, Larson DL, Severinac RN, et al. Rectus abdominis muscle innervation:implications for TRAM flap elevation [J]. Plast Reconstr Surg,1995,96(1):105-110.
[40]Nahabedian MY, Momen B, Galdino G, et al. Breast reconstruction with the free TRAM or DIEP flap:Patient selection, choice of flap, and outcome [J]. Plast Reconstr Surg,2002,110(2):466-477.
[41]Blondeel N, Vanderstraeten GG, Monstrey SJ, et al. The donor site morbidity of free DIEP flaps and free TRAM flaps for breast reconstruction [J]. Br J Plast Surg,1997,50(5):322-330.
[42]Nahabedian MY, Dooley W, Singh N, et al. Contour abnormalities of the abdomen after breast reconstruction with abdominal flaps:The role of muscle Preservation [J]. Plast Reconstr Surg,2002,109(1):91-101.
[43]Futter CM, Hagen WS, Mitchell SL. A retrospective comparison of abdominal muscle strength following breast reconstruction with a free TRAM or DIEP flap [J]. B J Plast Surg,2000,53(7):578-583.
[44]Heirmann C, Felmerer G, Durmus C, et al. Anatomical features of perforator blood vessels in the deep inferior epigastric perforator flap [J]. Br J Plast Surg,2000,53(7):205-208.
[45]Blondeel PN, Beyens G, Verghaege R, et al. Doppler flowmetry in the planning of perforator flaps [J]. Br J J Plast Surg,1998,51 (3):202-206.
[46]Hallock GG. Doppler sonography and colour duplex imaging for planning a perforator flap [J]. Clin Plast Surg,2003,30(3):345-357.
[47]Rolf J, Claudia F, Evelyn W, et al. Contrast-enhanced MR angiography of peripheral arteries including pedal vessels at 1.OT:feasibility study with dedicated peripheral angiography coil [J]. Radiology,2005,235:319-326.
[48]J Masia, JA Clavero, JR Larranaga, et al. Mul tidetector-row computed tomography in the planning of abdominal perforator flaps [J]. J Plas Reconstr Aesth Surg,2006,59(6):594-599.
[49]Min qiangxin, Lanhua Mu, Jie Luan. The value of multidetector-row CT angiography for pre-operative planning of breast reconstruction with deep inferior epigastric arterial perforator flaps [J]. Br J Radiol,2010, 83(985):40-43.
[50]Chang DW, Wang B, Robb GL, et al. Effect of obesity on flap and donor-site complications in free transverse rectus abdominis myocutaneous flap breast reconstruction [J]. Plast Reconstr Surg,2000, 105(5):1640-1648.
[51]Suominen S, Asko-Sel javaaar S, von Smitten K, et al. Sequelae in the abdominal wall after Pedieled or free TRAM flap surgery [J]. Ann Plast Surg,1996,36(6):629-636.
[52]Kroll SS, Schustemran MA, Reece GP et al. Abdominal wall strength, bulging, and hernia after TRAM flap breast reconstruction [J]. Plast Reeonstr Surg,1995,96(3):616-619.
[53]Patrick B, Edward W, Barbara A, et al. DIEP and pedicled TRAM flaps: a comparison of outcomes [J]. Plast Reconstr Surg,2006,117(6): 1711-1719.
[54]Mark Ak, Duch TN, Mark R, et al. Institutional review of free TRAM flap breast reconstruction [J]. Ann Plast Surg,2006,56(6):593-598.
[55]Charlotte H, Martina M, Eugen H, et al. The versatility of the SIEA flap:a clinical assessment of the vascular territory of the superficial epigastric inferior artery [J]. J Plas Reconstr Aesth Surg,2007,60(8): 946-951.
[56]Chevray PM. Breast reconstruction with superficial inferior epigastric artery flaps:a prospective comparision with TRAM and DIEP flaps [J]. Plast Reconstr Surg,2004,114(5):1077-1083.
[57]Reardon, Ceallaigh, Sullivan. An anatomical study of the superficial inferior epigastric vessels in humans [J]. Br J Plast Surg,2004,57(3): 515-519.
[58]栾杰,穆大力,穆兰花,辛敏强.应用SIEA皮瓣行乳房再造[J].中国美容医学,2009,18(2)：143-144.
[59]Stern HS, Nahai F. The versatile superficial inferior epigastric artery free flap [J]. Br J Plast Surg,1992,95(4):270-274.
[60]Chevray PM. Breast reconstruction with superficial inferior epigastric artery flaps:a prospective comparison with TRAM and DIEP flaps [J]. Plast Reconstr Surg,2004,114(5):1077-1083.
[61]Wolfram D, Schoeller T, Hussl H, Wechselberger G. The superficial inferior epigastric artery (SIEA) flap:indications for breast reconstruction [J]. Ann Plast Surg,2006,57(6):593-596.
[62]Scheflan, M., and Dinner, M.I. The transverse abdominal island flap: Part I. Indications, contraindications, results, and complications [J]. Ann Plast Surg,1983,10(1):24-35.
[63]Scheflan, M., and Dinner, M. I. The transverse abdominal island flap: Part Ⅱ. Surgical technique [J]. Ann Plast Surg,1983,10(2):120-129.
[64]Moon HK, Taylor GI. The vascular anatomy of rectus abdominis musculocutaneous flaps based on the deep inferior epigastric system [J]. Plast Reconstr Surg,1988,82(5):815-829.
[65]Holm, C., Mayr, M., Hofter, E., et al. Perfusion zones of the DIEP flap revisited:A clinical study [J]. Plast Reconstr Surg,2006,117(1): 37-43.
[66]Tregaskiss. Perfusion Zones of the DIEP Flap Revisited:A Clinical Study [J]. Plast Reconstr Surg,2006,118(3):816-817.
[67]Shoaib T, Marucci D. Adjacent Angiosomes Instead of Zones Ⅱ and Ⅲ: Reply to "Perfusion Zones of the DIEP Flap Revisited--A Clinical Study" [J]. Plast Reconstr Surg,2006,118(3):817-818.
[68]Heitmann C, Felmerer G, DURmus C, et al. Anatomical features of perforator blood vessels in the deep inferior epigastric perforator flap [J]. Br J Plast Surg,2000,53(3):205-208.
[69]Blondeel PN. One hundred free DIEP flap breast reconstructions:a personal experience [J]. Br J Plast Surg,1999,52(2):104-111.
[70]Vandevoort M, Vranckx JJ, Fabre G. Perforator topography of the deep inferior epigastric perforator flap in 100 cases of breast reconstruction [J]. Plast Reconstr Surg,2002,109(6):1912-1918.
[71]Munhoz AM, Ishida LH, Sturtz GP, et al. Importance of lateral row perforator vessels in deep inferior epigastric perforator flap harvesting [J]. Plast Reconstr Surg,2004,113(2):517-523.
[72]Keller A. The deep inferior epigastric perforator free flap for breast reconstruction [J]. Ann Plast Surg,2001,46(5):474-480.
[73]Cheng MH, Robles JA, Gozel B, et al. Reliability of zone IV in the deep inferior epigastric perforator flap:A single center's experience with 74 cases [J]. The Breast Journal,2006,15(2):158-166.
[74]Marino H, Dogliotti P. Mammary reconstruction with bipedicled abdominal flaps [J]. Plast Reconstr Surg,1981,68(6):933.
[75]Ishii CH, Bostwick J, Raine TJ, et al. Double-pedicled transverse rectus abdominis myocutaneous flap for unilateral breast and chest wall reconstruction [J]. Plast Reconstr Surg,1985,76(4):901-910.
[76]Wagner DS, Michelow BJ, Hartrampf CR. Double-pedicled TRAM flap breast reconstruction [J]. Plast Reconstr Surg,1991,88(6):987-997.
[77]Amez ZM, Scamp T. The bipedicled free TRAM flap [J]. Br J Plast Surg, 1992,45(3):214-218.
[78]Paige KT, Bostwick J III, Bried JT, et al. A comparison of morbidity from bilateral, unipedicled and unilateral, unipedicled TRAM flap breast reconstructions [J]. Plast Reconstr Surg,1998,101(7):987-997.
[79]Jayant PA, Lawrence JG. Double Pedicle Deep Inferior Epigastric Perforator/Muscle-Sparing TRAM Flaps for Unilateral Breast Reconstruction [J]. Ann Plast Surg,2007,58(4):359-363.
[80]Selber, Jesse C, Kurichi,et al. Risk Factors and Complications in Free TRAM Flap Breast Reconstruction [J]. Ann Plas Surg,2006,56(5): 492-497.
[81]Elisabeth KB, Robert LW. The Efficacy of Bilateral Lower Abdominal Free Flaps for Unilateral Breast Reconstruction [J]. Plast Reconstr Surg, 2007,120(1):41-54.
[82]Reece GP, Kroll SS. Abdominal wall comlications. Prevention and treatment [J]. Clin Plast Surg,1998,25(2):235-249.
[83]Boyd JB, Markland B, Dorion D, et al. Surgical augmentation of skin blood flow and viability in a pig musculocutaneous flap modal [J]. Plast Reconstr Surg,1990,84(4):731-739.
[84]Dorion D, Boyed JB, Pang CY. Augmentation of transmidline skin perfusion and viability in transverse rectus abdominis myocutaneous (TRAM) flaps in the pig [J]. Plast Reconstr Surg,1991,88(4):642-649.
[85]Ozgentas HE, Shenaq S, Spira M. Study of the delay phenomenon in the rat TRAM flap modal [J]. Plast Reconstr Surg,1994,94(7):1018-1024.
[86]Restifo RJ, Ahmed SS, Isenberg JS, et al. Timing, magnitude, and utility of surgical delay in the TRAM flap:1. animal studies [J]. Plast Reconstr Surg,1997,99(5):1211-1216.
[87]Aydin MA, Mavili ME. Examining microcirculation improves the angiosome theory in explaning the delay phenomenon in a rabbit model [J]. J Reconstr Microsurg,2003,19(3):187-194.
[88]Hallock GG, Rice DC. Evidence for the efficacy of TRAM flap delay in a rat modal [J]. Plast Reconstr Surg,1995,96(6):1351-1357.
[89]Sano K, Hal lock GG, Rice DC. The relative importance of the deep and superficial vascular systems for delay of the transverse rectus abdominis musculocutaneous flap as demonstrated in a rat model [J]. Plast Reconstr Surg,2002,109(3):1052-1057.
[90]Restifo RJ, Ahmed SS, Isenberg JS, et al. Timing. Magnitude, and utility of surgical delay in the TRAM flap:II. Clinical studies [J]. Plast Reconstr Surg,1997,99(5):1217-1223.
[91]Codner MA, Bostwick J Ⅲ, Nahai F, et al. TRAM flap vascular delay for high-risk breast reconstruction [J]. Plast Reconstr Surg,1995, 96(7):1615-1622.
[92]Erdmann D, Sundin BM, Moquin KJ, et al. Delay in unipedicled TRAM flap reconstruction of the breast:a review of 76 consecutive cases [J]. Plast Reconstr Surg,2002,110(3):762-767.
[93]Restifo RJ, Ahmed SS, Rosser J, et al. TRAM flap perforator ligation and the delay phenomenon:development of an endoscopic/laparoscopic delay procedure [J]. Plast Reconstr Surg,1998,101(6):1503-1511.
[94]Scheufler 0, Andresen R, Kirsch A, et al. Clinical results of TRAM flap delay by selective embolization of the deep inferior epigastric arteries [J]. Plast Reconstr Surg,2000,105(4):1310-1329.
[95]Karacaoglu E, Yuksel F, Turan SO, et al. Chemical delay:an alternative to surgical delay experimental study [J]. Ann Plast Surg,2002, 49(1):73-80.
[96]Ardalan E, Peter C, Peter W, et al. TRAM flap delay:an extraperitoneal laparoscopic technique [J]. ANZ J Surg,2005,75(10): 911-913.
[97]Berrino P, Santi PL. Hemodynamic analysis of the TRAM. Application to the "recharged TRAM" flap [J]. Clin Plast Surg,1994,21 (2):233-245.
[98]Berrino P, Casabona F, Adami M, et al. The "parasite" TRAM flap for autogenous tissue breast reconstruction in patients with vertical, idabdominal scars [J]. Ann Plast Surg,1999,43(2):119-126.
[99]Semple JL. Retrograde microvascular augmentation (turbocharging) of a single-pedicle TRAM flap through a deep inferior epigastric arterial and venous loop [J]. Plast Reconstr Surg,1994,93(1):109-117.
[100]Moustapha H, Dana KK, Koenraad VL, et al. Double-pedicle abdominal perforator free flaps for unilateral breast reconstruction:new horizons in microsurgical tissue transfer to the breast [J]. J Plast Reconstr Aesthet Surg,2007,60(8):904-912.
[101]Longmire, W. P. A modification of the Roux technique for antethoracic esophageal reconstruction [J]. Surgery,1947,22:94-100.
[102]Blondeel PN, Arnstein M, Verstraete K, et al. Venous congestion and blood flow in free transverse rectus abdominis and deep inferior epigastric perforator flaps [J]. Plast Reconstr Surg,2000,106(6): 1295-1299.
[103]Nho V. Tran, Edward W. Buchel, Phyllis A. Convery. Microvascular Complications of DIEP Flaps [J]. Plast Reconstr Surg,2007,119(5): 1397-1405.
[104]Harashina T, Sone K, Inoue T, et al. Augmentation of circulation of pedicled transverse rectus abdominis musculocutaneous flaps by microvascular surgery [J]. Br J Plast Surg,1987,40(4):367-370.
[105]Tuominen Hp, Asko-Seljabaara S, Svartling NE. Cutaneous blood flow in the free TRAM flap [J]. Br J Plast Surg,1993,46(8):665-669.
[106]Mrakby HH, Milner RH, McLean NR. Supercharged Pedicled TRAM Flap in Breast Reconstruction:Is It a Worthwhile Procedure [J]. Ann Plast Surg, 2002,49 (3):252-257.
[107]BarBarnett GR, Carlisle IR, Gianoutsos MP. The cephalic vein:an aid in free TRAM flap breast reconstruction. Report of 12 cases [J]. Plast Reconstr Surg,1996,97(1):71-76.
[108[Yanaga H, Tai Y, Kiyokawa K, et al. An ipsilateral superdrainaged transverse rectus abdominis myocutaneous flap for breast reconstruction [J]. Plast Reconstr Surg,1999,103(2):465-472.
[109]Yusuke Yamamoto, Hiroyuki Sakurai, Hiroaki Nakazawa, et al. Effect of vascular augmentation on the haemodynamics and survival area in a rat abdominal perforator flap model [J]. J Plast Reconstr Aesthet Surg,2009, 62(2):244-249.
[110]Geoffrey G. Hallock, and David C. Rice. Efficacy of Venous Supercharging of the Deep Inferior Epigastric Perforator Flap in a Rat Model [J]. Plast Reconstr Surg,2005,116(2):552-555.
[111]Hak Chang, Kyung Won Minn, Nobuaki Imanishi, et al. Effect of Venous Superdrainage on a Four-Territory Skin Flap Survival in Rats [J]. Plast Reconstr Surg,2007,119(7):2046-2051.
[112]Stell PM. The pig as an experimental model for skin flap behaviour a reappraisal of previous studies [J]. Br J Plast Surg,1977,30(1):1-8.
[113]Sullivan TP, Eaglstein WH, Davis SC, et al. The pig as a model for human wound healing [J]. Wound Repair Regen,2001,9(2):66-76.
[114]Zhong A, Pang CY, Sheffied WD, et al. Augmentation of acute random pattern skin flap viability in the pig [J]. J Surg Res,1992, 52(2):177-183.
[115]Massey MF, Gupata DK. The effects of systemic phenylephrine and epinephrine on pedicle artery and microvascular perfusion in a pig model of myoadipocutaneous rotational flaps [J]. Plast Reconstr Surg,2007, 120(5):1289-1299.
[116]Kerrigan CL. Zelt RG, Thomson JG, et al. The pig as an experimental animal in plastic surgery research for the study of skin flaps, myocutaneous flaps and fasciocutaneous flaps [J]. Lab Anim Sci,1986, 36(4):408-412.
[117]Jin Mei, ZhiXun Yin, Ji Zhang, et al. A mini pig model for visualization of perforator flap by using angiography and MIMICS [J]. Surg Radiol Anat,2009,14(published online).
[118]Daniel RK, Kerrigan CL. The omnipotential pig buttock flap [J]. Plast Reconstr Surg,1982,70(1):11-16.
[119]Haughey BH, Panje WR. A porcine model for multiple musculocutaneous flaps [J]. Laryngoscope,1989,99(2):204-212.
[120]Dor ion D, Boyed JB, Pang CY. Augmentation of transmidline skin perfusion and viability in transverse rectus abdominis myocutaneous (TRAM) flaps in the pig [J]. Plast Reconstr Surg,1991,88(4):642-649.
[121]Cederna PS, Chang P, Pittet Cuenod BM, et al. The Effect of Epigastric Vessel Ligation on the Vascular Territories of Epigastric Vessel Ligation on the Vascular Territories of the pig Rectus Muscle [J]. Plast Reconstr Surg,1997,99(1):194-205.
[122]Taylor GI, Watterson PA, Zelt RG. The vascular anatomy of the anterior abdominal wall:The basis for flap design [J]. Perspect in Plast Surg,1991,5(1):1-30.
[123]Kaufman T, Hunwitz DJ, Boehnke M, et al. The microsirculatory pattern of the transverse-abdominal flap:A cross-sectional Xerographic and CT scanning study [J]. Ann Plast Surg,1985,14(4):340-345.
[124]Gottfried W, Thomas S, Thomas B, et al. Venous Superdrainage in Deep Inferior Epigastric Perforator Flap Breast Reconstruction [J]. Plast Reconstr Surg,2001,109(1):162-166.
[125]Hamdi M, Weiler-Mithoff, DM, and Webster MIIC. Deep inferior epigastric perforator flap in breast reconstruction:Experience with the first 50 flaps [J]. Plast Reconstr Surg,1999,103(1):86-95.
[126]Wechselberger G, Schoeller T, Bauer T, et al. Venous superdrainage in deep inferior epigastric perforator flap breast reconstruction [J]. Plast Reconstr Surg,2001,108(1):162-166.
[127]Blondeel P N. One hundred free DIEP flap breast reconstructions: A personal experience [J]. Br J Plast Surg,1999,52(2):104-111,
[128]Nakayama Y, Soeda S, Kasai Y. The importance of arterial inflow in the distal side of a flap:an experimental investigation [J]. Plast
Reconstr Surg,1982,69(1):61-67.
[129]Ueda K, Harashina T, Oba S, et al. Which vessel is more important in the supercharged flap:artery, vein, or both? An experimental study [J]. J Reconstr Microsurg,1994,10(3):153-155.
[130]Roberts AP, Cohen JI, Cook TA. The rat ventral island flap:a comparison of the effects of reduction in arterial inflow and venous outflow [J]. Plast Reconstr Surg,1996,97(3):610-615.
[131]Miyamoto Shimpei, Minabe Toshiharu, HariiKiyonori. Effect of Recipient Arterial Blood Inflow on Free Flap Survival Area [J]. Plast Reconstr Surg,2008,121(2):505-513.
[132]Smith, P. J. The importance of venous drainage in axial pattern flaps in pigs [J]. Br J Plast Surg,1978,31(3):233-237.
[133]Fujino T. Contribution of the axial and perforator vasculature to circulation in flaps [J]. Plast Reconstr Surg,1967,39(2):125.
[134]Niranjan NS, Khandwala AR, Mackenzie DM. Venous augmentation of the free TRAM flap [J]. Br J Plast Surg,2001,54(4):335-337.
[135]Hallock GG, and Rice DC. Comparison of TRAM and DIEP flap physiology in a ratmodel [J]. Plast Reconstr Surg,2004,114(5):1179-1184.
[136]Cheng H, Luo Q, Liu Q, et al. Laser specie imaging of blood flow in microcirculation [J]. Phys Med Biol,2004,49(7):1347-1357.
[137]JD Briers. Laser Doppler, speckle and related techniques for blood perfusion mapping and imaging [J]. Physiol Meas,2001,22:R35.
[138]Kroll SS, Schusterman MA, Reece GP, et al. Timing of pedicle thrombosis and flap loss after free-tissue transfer [J]. Plast Reconstr Surg,1996,98(7):1230-1283.
[139]Hauge EM, Balling E, Hartmund T, et al. Secondary ischemia caused by venous or arterial occlusion shows differential effects on myocutaneous island flap survival and muscle ATP levels [J]. Plast Reconstr Surg,1997,99(3):825-833.
[140]Kerrigan CL, Wizman P, Hjortdal VE, et al. Global flap ischemia: A comparison of arterial versus venous etiology [J]. Plast Reconstr Surg, 1994,93(7):1485-1485.
[141]Yuen JC, and Feng Z. Monitoring free flaps using the laser Doppler flowmeter:Five-year experience [J]. Plast Reconstr Surg,2000,105(1): 55-61.
[142]Heller L, Levin LS, and Klitzman B. Laser Doppler flowmeter monitoring of free-tissue transfers:Blood flow in normal and complicated cases [J]. Plast Reconstr Surg,2001,107(7):1739-1745.
[143]Mailaender P, Machens HG, Waurick R, et al. Routine monitoring in patients with free tissue transfer by laser-Doppler flowmetry [J]. Microsurgery,1994,15(3):196-202.
[144]Fischer JC, Parker PM, and Shaw WW. Waveform analysis applied to laser Doppler flowmetry [J]. Microsurgery,1986,7(2):67-71.
[145]Hudson DA, Engelbrecht G, and Duminy FJ. Another method to prevent venous thrombosis in microsurgery:An in situ venous catheter [J]. Plast Reconstr Surg,2000,105(3):999-1003.
[146]Moon VH. Disturbance of circulation [A]. In:Anderson W, editor. Pathology [M]. St. Louis:The C.V. Mosby Company,1953:92.
[147]Rooks MD, Gould JS, Masear V, et al. Effects of venous hypertension on rabbit free flap survival [J]. Microsurgery,1991,12(4):253-261.
[148]Sakurai, Hiroyuki, Nozaki, et al. Monitoring the Changes in Intraparenchymatous Venous Pressure to Ascertain Flap Viability [J]. Plast Reconstr Surg,2007,119(7):2111-2117.
[149]Gregory TL, Aaron KR, Peter Herman, et al. Capillary blood gas:A novel means of assessing free flap perfusion in an animal model [J]. Otolaryngology-Head and Neck Surgery,2008,139(2):250-255.
[150]Harrison AM, Lynch JM, Dean JM, et al. Comparison of simultaneously obtained arterial and capillary blood gases in pediatric intensive care unit patients [J]. Crit Care Med,1997,25(11):1904-1908.
[151]Yildizdas D, Yapicioglu H. Yilmaz HL, et al. Correlation of simultaneously obtained capillary, venous, and arterial blood gases of patients in a paediatric intensive care unit [J]. Arch Dis Child,2004, 89:176-80.
[152]Liss AG, Liss P. Use of a modified oxygen microelectrode and laserDoppler flowmetry to monitor changes in oxygen tension and microcirculation in a flap [J]. Plast Reconstr Surg,2000,105(6): 2072-2078.
[153]Pryor SG, Moore EJ, Kasperbauer JL. Implantable Doppler flow system: experience with 24 microvascular free-flap operations [J]. Otolaryngol Head Neck Surg,2006,135(5):714-718.
[154]Raskin DJ, Erk Y, Spira M, et al. Tissue pll monitoring in microsurgery:a preliminary evaluation of continuous tissue pH monitoring as an indicator of perfusion disturbances in microvascular free flaps [J]. Ann Plast Surg,1983,119(4):331-339.
[155]Warner KG, Durham-Smith G, Butler MD, et al. Comparative response of muscle and subcutaneous tissue pH during arterial and venous occlusion in musculocutaneous flaps [J]. Ann Plast Surg,1989,22(2):108-116.
[156]Hofer SO, van der Kleij AJ, Grundeman PF, et al. Continuous tissue oxygenation assessment during bloodflow alterations in an isolated hindlimb model of the pig [J]. Adv Exp Med Biol,1994,345:693-700.
[157]Hirigoyen MB, Blackwell KE, Zhang WX, et al. Continuous tissue oxygen tension measurement as a monitor of free-flap viability [J]. Plast Reconstr Surg,1997,99(3):763-773.
[158]Tuominen HP, Asko-Seljavaara S, Svartling NE, et al. Cutaneous blood flow in the TRAM flap [J]. Br J Plast Surg,1992,45(4):261-269.
[159]Tuominen HP, Asko-Seljavaara S, Svartling NE. Cutaneous blood flow in the free TRAM flap [J]. Br J Plast Surg,1993,46(8):665-669.
[160]Finseth F, Cutting C. An experimental neurovascular island skin flap for the study of the delay phenomenon [J]. Plast Reconstr Surg,1978, 61(3):412-420.
[161]Zachary LS, Heggers JP, Robson MC, et al. Combined prostacyclin and thromboxane synthetase inhibitor UK 38485 in flap survival [J]. Ann Plast Surg,1986,17(2):112-115.
[162]Carramenha e Costa MA, Carriquiry C, Vasconez LO, et al. An anatomic study of the venous drainage of the transverse rectus abdominis musculocutaneous flap [J]. Plast Reconstr Surg,1987,79(2):208-208.
[163]Taylor GI, Caddy CM, Watterson PA, et al. The venous territories (venosomes) of the human body:Experimental study and clinical implications [J]. Plast Reconstr Surg,1990,86(2):185-185.
[164]Villafane 0, Gahankari D, Webster M. Superficial inferior epigastric vein (SIEV):'lifeboat'for DIEP/TRAM flaps [J]. Br J Plast Surg,1999,52:597-601.
[165]Imanishi N, Nakajima H, Minabe T, et al. Anatomical relationship between arteries and veins in the paraumbilical region [J]. Br J Plast Surg,2003,56(6):552-556.
[166]Holmstrom H. The free abdominoplasty flap and its use in breast reconstruction [J]. Scand J Plast Reconstr Surg,1979,13(3):423-427.
[167]Kroll SS. Free tram flap breast reconstruction after skin-sparing mastectomy [J]. Oper Tech Plast Surg,1999,6(1):22-26.
[168]Kroll SS, Gherardini G, Martin JE, et al. Fat necrosis in free and pedicled TRAM flaps [J]. Plast Reconstr Surg,1998,102(5):1502-7.
[169]Beckenstein MS, Grotting JC. Breast reconstruction with free-tissue transfer [J]. Plast Reconstr Surg,2001,108(5):1345-53.
[170]Marzia S, Liliana BA, Marcella S, et al. Needing a large DIEAP flap for unilateral breast reconstruction:Double-pedicle flap and unipedicle flap additional venous discharge [J]. Microsurgery,2010,30(2): 111-117.
[171]Blondeel PN, Boeckx WD. Refinements in free flap breast reconstruction:the free bilateral deep inferior epigastric perforator flap anastomosed to the internal mammary artery [J]. Br J Plast Surg,1994, 47(7):495-501.
[172]Blondeel PN, Van Landuyt KH, Montres SJ. Surgical-technical aspects of the free DIEP flap for breast reconstruction [J]. Oper Tech Plast Surg, 1999,6(1):27-37.
[172]Kroll SS. Free TRAM of DIEP flap:which to choose [J]. Oper Tech Plast Surg,1999,6(1):83-85.
[173]Lee JW, Lee YC, Chang TW. et al. Microvascularly augmented transverse rectus abdominis myocutaneous flap for breast reconstruction-reappraisal of its value through clinical outcome assessment and intraoperative blood gas analysis [J]. Microsurg,2008, 28(8):656-662.
[2]Hartrampf CR. Transverse abdominal island flap technique for breast reconstruction after mastectomy [M]. Baltimore:University Park Press, 1984:84.
[3]Restifo RJ, Ahmed SS, Isenberg JS, et al. Timing, magnitude, and utility of surgical delay in the TRAM flap:II. Clinical studies [J]. Plast Reconstr Surg,1997,99(5):1217-1223.
[4]Harashina T, Sone T, et al. Augmentation of circulation of pedicled transverse rectus abdominis musculocutaneous flaps by microvascular surgery [J]. Br J Plast Surg,1987,40(4):367-370.
[5]Beegle PH. Microvascular augmentation of TRAM flap circulation (Supercharged TRAM)[A]. In Hatrampf CR. Hartrampf's Breast Reconstruction with Living Tissue [M]. Norfork:Hampton Press,1991:151.
[6]Berrino P, Santi PL. Hemodyna(?)ic analysis of the TRAM. Application to the "Recharged TRAM" flap [J]. Clin Plast Surg,1994,2(2):233-245.
[7]Berrino P, Casabona F, Adami M, et al. The "TRAM" flap for autologus tissue breast reconstruction in patients with vertical midabdominal scars [J]. Ann Plast Surg,1999,43(2):119-126.
[8]Holmstrom H. The free abdominoplasty flap and its use in breast reconstruction. An experimental study and clinical case report [J]. Scand J Plast Reconstr Surg,1979,13(3):423-427.
[9]Amez ZM, Smith RW, Eder E, et al. Breast reconstruction by the free lower transverse rectus abdominis musculocutaneous flap [J]. Br J Plast Surg,1988,41(5):500-505.
[10]Grotting JC, Urist MM, Maddox WA, et al. Convebtional TRAM versus free microsurgical TRAM flap for immediate breast reconstruction [J]. Plast Reconstr Surg,1989,83(4):828-833.
[11]Koshima I, Soeda S. Inferior epigastric artery skin flaps without rectus abdominis muscle [J]. Br J Plast Surg,1989,42(7):645-648.
[12]Kroll SS. Fat necrosis in free transverse rectus abdominus myocutaneous and deep inferior epigastric perforator flaps [J]. Plast Reconstr Surg,2000,106(3):576-583.
[13]Hamdi M, Weiler-Mithoff EM, Webster MH. Deep inferior epigastric perforator flap in breast reconstruction:experience with the first 50 flaps [J]. Plast Reconstr Surg,1999,103(1):86-95.
[14]Keller A. The deep inferior epigastric perforator free flap for breast reconstruction [J]. Ann Plast Surg,2001,46(1):474-479.
[15]Nahabedian MY, Momen B, Galdino G, et al. Breast reconstruction with the free TRAM or DIEP flap:patient selection, choice of flap, and outcome [J]. Plast Reconstr Surg,2002,110(2):466-475.
[16]Allen RJ, Treece P. Deep inferior epigastric perforator flap for breast reconstruction [J]. Ann Plast Surg,1994,32(1):32-38.
[17]Taylor GI, Daniel RK. The anatomy of several free flap donor sites [J]. Plast Reconstr Surg,1975,56(3):243-253.
[18]Grotting JC. The free abdominoplasty flap for immediate breast reconstruction [J]. Ann Plast Surg,1991,27(4):351-354.
[19]Taylor GI. An anatomical study of the venous drainage of the transverse rectus abdominis musculocutaneous flap (discussion) [J]. Plast Reconstr Surg,1987,79(2):216-217.
[20]Hartrampf CR, Bennett GK. Autologus tissue reconstruction in the mastectomy patient:clinical review of 300 patients [J]. Ann Surg,1987, 205(5):508-519.
[21]Wagner DS, Michelow BJ, Hartrampf CR. Double-pedicled TRAM flap for unilateral breast reconstruction [J]. Plast Reconstr Surg,1999,88(6): 987-997.
[22]Kroll SS, Marchi M. Comparison of strategies for preventing abdominal-wall weakness after TRAM flap breast reconstruction [J]. Plast Reconstr Surg,1992,89(6):1045-1051.
[23]Beastly ME. The pedicled TRAM as preference for immediate autogeneous tissue breast reconstruction [J]. Clin Plast Surg,1994,21(2):191-205.
[24]Watterson PA, Bostwick J III, Hester TR, Bried JT, et al. TRAM flap anatomy correlated with a 10-year clinical experience with 556 patients [J]. Plast Reconstr Surg,1995,95(7):1185-1194.
[25]Clugston PA, Gingrass MK, Azurin D, et al. Ipsilateral pedicled TRAM flaps:the safer alternative [J]? Plast reconstr Plast,2000,105(1): 77-82.
[26]Paige KT, Bostwick J III, Bried JT, et al. A comparison of morbidity from bilateral, unipedicled and unilateral, unipedicled TRAM flap breast reconstructions [J]. Plast Reconstr Surg,1998,10(7):1819-1827.
[27]Kroll SS, Coffey JA, Winning RJ, et al. An comparison of factors affecting aesthetic outcomes of TRAM flap breast reconstructions [J]. Plast Reconstr Surg,1995,96(4):860-864.
[28]Grotting JC, Urist MM, Maddox WA, et al. Conventional TRAM versus free microsurgical TRAM flap for immediate breast reconstruction [J]. Plast Reconstr Surg,1989,83(4):828-833.
[29]Serletti JM, Moran SL. Free versus the pedicled TRAM flap:a cost comparison and outcome analysis [J]. Plast Reconstr Surg,1997,100(6): 1418-1424.
[30]Moran SL, Serletti JM. Outcome comparison between free and pedicled TRAM flap breast reconstruction in the obese patient [J]. Plast Reconstr Surg,2001,108(7):1954-1960.
[31]Emi D, Harder YD. The dissection of the rectus abdominis myocutaneous flap with complete preservation of the anterior rectus sheath [J]. Br Assoc Plast Surg,2003,56(4):395-400.
[32]Suominen S, Asko-Seljavaara S, von Smitten K, et al. Sequelae in the abdominal wall after pedicled or free TRAM flap surgery [J]. Ann Plast Surg,1996,36(6):629-636.
[33]Elliott LF, Eskenazi L, Beegle PH, et al. Immediate TRAM flap breast reconstruction:128 consecutive cases [J]. Plast Reconstr Surg,1993, 92(2):217-227.
[34]Schusterman MA, Kroll SS, Weldom ME. Immediate breast reconstruction: Why the free TRAM over the conventional TRAM flap [J]? Plast Reconstr Plast, 1992,90(2):255-261.
[35]Gherardini G, Amander C, Gylbert L, et al. Pedicles compared with free transverse rectus abdominis myocutaneous flaps in breast reconstruction [J]. Scand J Plast Reconstr Surg Hand Surg,1994,28(1): 69-73.
[36]Baldwin BJ, Schusterman MA, Miller MJ, et al. Bilateral breast reconstruction:conventional versus free TRAM [J]. Plast Reconstr Surg, 1994,93(7):1410-1416.
[37]Suominen S, Tervahartiala P, von Smitten K, et al. Megnetic resonance imaging of the TRAM flap donor site [J]. Ann Plast Surg,1997,38(1):23-28.
[38]Duchateau J, Declety A, Lejour M. Innervation of the rectus abdominis muscle:implications for rectus flaps [J]. Plast Reconstr Surg,1988,82(2): 223-227.
[39]Hammond DC, Larson DL, Severinac RN, et al. Rectus abdominis muscle innervation:implications for TRAM flap elevation [J]. Plast Reconstr Surg,1995,96(1):105-110.
[40]Nahabedian MY, Momen B, Galdino G, et al. Breast reconstruction with the free TRAM or DIEP flap:Patient selection, choice of flap, and outcome [J]. Plast Reconstr Surg,2002,110(2):466-477.
[41]Blondeel N, Vanderstraeten GG, Monstrey SJ, et al. The donor site morbidity of free DIEP flaps and free TRAM flaps for breast reconstruction [J]. Br J Plast Surg,1997,50(5):322-330.
[42]Nahabedian MY, Dooley W, Singh N, et al. Contour abnormalities of the abdomen after breast reconstruction with abdominal flaps:The role of muscle Preservation [J]. Plast Reconstr Surg,2002,109(1):91-101.
[43]Futter CM, Hagen WS, Mitchell SL. A retrospective comparison of abdominal muscle strength following breast reconstruction with a free TRAM or DIEP flap [J]. B J Plast Surg,2000,53(7):578-583.
[44]Heirmann C, Felmerer G, Durmus C, et al. Anatomical features of perforator blood vessels in the deep inferior epigastric perforator flap [J]. Br J Plast Surg,2000,53(7):205-208.
[45]Blondeel PN, Beyens G, Verghaege R, et al. Doppler flowmetry in the planning of perforator flaps [J]. Br J J Plast Surg,1998,51 (3):202-206.
[46]Hallock GG. Doppler sonography and colour duplex imaging for planning a perforator flap [J]. Clin Plast Surg,2003,30(3):345-357.
[47]Rolf J, Claudia F, Evelyn W, et al. Contrast-enhanced MR angiography of peripheral arteries including pedal vessels at 1.OT:feasibility study with dedicated peripheral angiography coil [J]. Radiology,2005,235:319-326.
[48]J Masia, JA Clavero, JR Larranaga, et al. Mul tidetector-row computed tomography in the planning of abdominal perforator flaps [J]. J Plas Reconstr Aesth Surg,2006,59(6):594-599.
[49]Min qiangxin, Lanhua Mu, Jie Luan. The value of multidetector-row CT angiography for pre-operative planning of breast reconstruction with deep inferior epigastric arterial perforator flaps [J]. Br J Radiol,2010, 83(985):40-43.
[50]Chang DW, Wang B, Robb GL, et al. Effect of obesity on flap and donor-site complications in free transverse rectus abdominis myocutaneous flap breast reconstruction [J]. Plast Reconstr Surg,2000, 105(5):1640-1648.
[51]Suominen S, Asko-Sel javaaar S, von Smitten K, et al. Sequelae in the abdominal wall after Pedieled or free TRAM flap surgery [J]. Ann Plast Surg,1996,36(6):629-636.
[52]Kroll SS, Schustemran MA, Reece GP et al. Abdominal wall strength, bulging, and hernia after TRAM flap breast reconstruction [J]. Plast Reeonstr Surg,1995,96(3):616-619.
[53]Patrick B, Edward W, Barbara A, et al. DIEP and pedicled TRAM flaps: a comparison of outcomes [J]. Plast Reconstr Surg,2006,117(6): 1711-1719.
[54]Mark Ak, Duch TN, Mark R, et al. Institutional review of free TRAM flap breast reconstruction [J]. Ann Plast Surg,2006,56(6):593-598.
[55]Charlotte H, Martina M, Eugen H, et al. The versatility of the SIEA flap:a clinical assessment of the vascular territory of the superficial epigastric inferior artery [J]. J Plas Reconstr Aesth Surg,2007,60(8): 946-951.
[56]Chevray PM. Breast reconstruction with superficial inferior epigastric artery flaps:a prospective comparision with TRAM and DIEP flaps [J]. Plast Reconstr Surg,2004,114(5):1077-1083.
[57]Reardon, Ceallaigh, Sullivan. An anatomical study of the superficial inferior epigastric vessels in humans [J]. Br J Plast Surg,2004,57(3): 515-519.
[58]栾杰,穆大力,穆兰花,辛敏强.应用SIEA皮瓣行乳房再造[J].中国美容医学,2009,18(2)：143-144.
[59]Stern HS, Nahai F. The versatile superficial inferior epigastric artery free flap [J]. Br J Plast Surg,1992,95(4):270-274.
[60]Chevray PM. Breast reconstruction with superficial inferior epigastric artery flaps:a prospective comparison with TRAM and DIEP flaps [J]. Plast Reconstr Surg,2004,114(5):1077-1083.
[61]Wolfram D, Schoeller T, Hussl H, Wechselberger G. The superficial inferior epigastric artery (SIEA) flap:indications for breast reconstruction [J]. Ann Plast Surg,2006,57(6):593-596.
[62]Scheflan, M., and Dinner, M.I. The transverse abdominal island flap: Part I. Indications, contraindications, results, and complications [J]. Ann Plast Surg,1983,10(1):24-35.
[63]Scheflan, M., and Dinner, M. I. The transverse abdominal island flap: Part Ⅱ. Surgical technique [J]. Ann Plast Surg,1983,10(2):120-129.
[64]Moon HK, Taylor GI. The vascular anatomy of rectus abdominis musculocutaneous flaps based on the deep inferior epigastric system [J]. Plast Reconstr Surg,1988,82(5):815-829.
[65]Holm, C., Mayr, M., Hofter, E., et al. Perfusion zones of the DIEP flap revisited:A clinical study [J]. Plast Reconstr Surg,2006,117(1): 37-43.
[66]Tregaskiss. Perfusion Zones of the DIEP Flap Revisited:A Clinical Study [J]. Plast Reconstr Surg,2006,118(3):816-817.
[67]Shoaib T, Marucci D. Adjacent Angiosomes Instead of Zones Ⅱ and Ⅲ: Reply to "Perfusion Zones of the DIEP Flap Revisited--A Clinical Study" [J]. Plast Reconstr Surg,2006,118(3):817-818.
[68]Heitmann C, Felmerer G, DURmus C, et al. Anatomical features of perforator blood vessels in the deep inferior epigastric perforator flap [J]. Br J Plast Surg,2000,53(3):205-208.
[69]Blondeel PN. One hundred free DIEP flap breast reconstructions:a personal experience [J]. Br J Plast Surg,1999,52(2):104-111.
[70]Vandevoort M, Vranckx JJ, Fabre G. Perforator topography of the deep inferior epigastric perforator flap in 100 cases of breast reconstruction [J]. Plast Reconstr Surg,2002,109(6):1912-1918.
[71]Munhoz AM, Ishida LH, Sturtz GP, et al. Importance of lateral row perforator vessels in deep inferior epigastric perforator flap harvesting [J]. Plast Reconstr Surg,2004,113(2):517-523.
[72]Keller A. The deep inferior epigastric perforator free flap for breast reconstruction [J]. Ann Plast Surg,2001,46(5):474-480.
[73]Cheng MH, Robles JA, Gozel B, et al. Reliability of zone IV in the deep inferior epigastric perforator flap:A single center's experience with 74 cases [J]. The Breast Journal,2006,15(2):158-166.
[74]Marino H, Dogliotti P. Mammary reconstruction with bipedicled abdominal flaps [J]. Plast Reconstr Surg,1981,68(6):933.
[75]Ishii CH, Bostwick J, Raine TJ, et al. Double-pedicled transverse rectus abdominis myocutaneous flap for unilateral breast and chest wall reconstruction [J]. Plast Reconstr Surg,1985,76(4):901-910.
[76]Wagner DS, Michelow BJ, Hartrampf CR. Double-pedicled TRAM flap breast reconstruction [J]. Plast Reconstr Surg,1991,88(6):987-997.
[77]Amez ZM, Scamp T. The bipedicled free TRAM flap [J]. Br J Plast Surg, 1992,45(3):214-218.
[78]Paige KT, Bostwick J III, Bried JT, et al. A comparison of morbidity from bilateral, unipedicled and unilateral, unipedicled TRAM flap breast reconstructions [J]. Plast Reconstr Surg,1998,101(7):987-997.
[79]Jayant PA, Lawrence JG. Double Pedicle Deep Inferior Epigastric Perforator/Muscle-Sparing TRAM Flaps for Unilateral Breast Reconstruction [J]. Ann Plast Surg,2007,58(4):359-363.
[80]Selber, Jesse C, Kurichi,et al. Risk Factors and Complications in Free TRAM Flap Breast Reconstruction [J]. Ann Plas Surg,2006,56(5): 492-497.
[81]Elisabeth KB, Robert LW. The Efficacy of Bilateral Lower Abdominal Free Flaps for Unilateral Breast Reconstruction [J]. Plast Reconstr Surg, 2007,120(1):41-54.
[82]Reece GP, Kroll SS. Abdominal wall comlications. Prevention and treatment [J]. Clin Plast Surg,1998,25(2):235-249.
[83]Boyd JB, Markland B, Dorion D, et al. Surgical augmentation of skin blood flow and viability in a pig musculocutaneous flap modal [J]. Plast Reconstr Surg,1990,84(4):731-739.
[84]Dorion D, Boyed JB, Pang CY. Augmentation of transmidline skin perfusion and viability in transverse rectus abdominis myocutaneous (TRAM) flaps in the pig [J]. Plast Reconstr Surg,1991,88(4):642-649.
[85]Ozgentas HE, Shenaq S, Spira M. Study of the delay phenomenon in the rat TRAM flap modal [J]. Plast Reconstr Surg,1994,94(7):1018-1024.
[86]Restifo RJ, Ahmed SS, Isenberg JS, et al. Timing, magnitude, and utility of surgical delay in the TRAM flap:1. animal studies [J]. Plast Reconstr Surg,1997,99(5):1211-1216.
[87]Aydin MA, Mavili ME. Examining microcirculation improves the angiosome theory in explaning the delay phenomenon in a rabbit model [J]. J Reconstr Microsurg,2003,19(3):187-194.
[88]Hallock GG, Rice DC. Evidence for the efficacy of TRAM flap delay in a rat modal [J]. Plast Reconstr Surg,1995,96(6):1351-1357.
[89]Sano K, Hal lock GG, Rice DC. The relative importance of the deep and superficial vascular systems for delay of the transverse rectus abdominis musculocutaneous flap as demonstrated in a rat model [J]. Plast Reconstr Surg,2002,109(3):1052-1057.
[90]Restifo RJ, Ahmed SS, Isenberg JS, et al. Timing. Magnitude, and utility of surgical delay in the TRAM flap:II. Clinical studies [J]. Plast Reconstr Surg,1997,99(5):1217-1223.
[91]Codner MA, Bostwick J Ⅲ, Nahai F, et al. TRAM flap vascular delay for high-risk breast reconstruction [J]. Plast Reconstr Surg,1995, 96(7):1615-1622.
[92]Erdmann D, Sundin BM, Moquin KJ, et al. Delay in unipedicled TRAM flap reconstruction of the breast:a review of 76 consecutive cases [J]. Plast Reconstr Surg,2002,110(3):762-767.
[93]Restifo RJ, Ahmed SS, Rosser J, et al. TRAM flap perforator ligation and the delay phenomenon:development of an endoscopic/laparoscopic delay procedure [J]. Plast Reconstr Surg,1998,101(6):1503-1511.
[94]Scheufler 0, Andresen R, Kirsch A, et al. Clinical results of TRAM flap delay by selective embolization of the deep inferior epigastric arteries [J]. Plast Reconstr Surg,2000,105(4):1310-1329.
[95]Karacaoglu E, Yuksel F, Turan SO, et al. Chemical delay:an alternative to surgical delay experimental study [J]. Ann Plast Surg,2002, 49(1):73-80.
[96]Ardalan E, Peter C, Peter W, et al. TRAM flap delay:an extraperitoneal laparoscopic technique [J]. ANZ J Surg,2005,75(10): 911-913.
[97]Berrino P, Santi PL. Hemodynamic analysis of the TRAM. Application to the "recharged TRAM" flap [J]. Clin Plast Surg,1994,21 (2):233-245.
[98]Berrino P, Casabona F, Adami M, et al. The "parasite" TRAM flap for autogenous tissue breast reconstruction in patients with vertical, idabdominal scars [J]. Ann Plast Surg,1999,43(2):119-126.
[99]Semple JL. Retrograde microvascular augmentation (turbocharging) of a single-pedicle TRAM flap through a deep inferior epigastric arterial and venous loop [J]. Plast Reconstr Surg,1994,93(1):109-117.
[100]Moustapha H, Dana KK, Koenraad VL, et al. Double-pedicle abdominal perforator free flaps for unilateral breast reconstruction:new horizons in microsurgical tissue transfer to the breast [J]. J Plast Reconstr Aesthet Surg,2007,60(8):904-912.
[101]Longmire, W. P. A modification of the Roux technique for antethoracic esophageal reconstruction [J]. Surgery,1947,22:94-100.
[102]Blondeel PN, Arnstein M, Verstraete K, et al. Venous congestion and blood flow in free transverse rectus abdominis and deep inferior epigastric perforator flaps [J]. Plast Reconstr Surg,2000,106(6): 1295-1299.
[103]Nho V. Tran, Edward W. Buchel, Phyllis A. Convery. Microvascular Complications of DIEP Flaps [J]. Plast Reconstr Surg,2007,119(5): 1397-1405.
[104]Harashina T, Sone K, Inoue T, et al. Augmentation of circulation of pedicled transverse rectus abdominis musculocutaneous flaps by microvascular surgery [J]. Br J Plast Surg,1987,40(4):367-370.
[105]Tuominen Hp, Asko-Seljabaara S, Svartling NE. Cutaneous blood flow in the free TRAM flap [J]. Br J Plast Surg,1993,46(8):665-669.
[106]Mrakby HH, Milner RH, McLean NR. Supercharged Pedicled TRAM Flap in Breast Reconstruction:Is It a Worthwhile Procedure [J]. Ann Plast Surg, 2002,49 (3):252-257.
[107]BarBarnett GR, Carlisle IR, Gianoutsos MP. The cephalic vein:an aid in free TRAM flap breast reconstruction. Report of 12 cases [J]. Plast Reconstr Surg,1996,97(1):71-76.
[108[Yanaga H, Tai Y, Kiyokawa K, et al. An ipsilateral superdrainaged transverse rectus abdominis myocutaneous flap for breast reconstruction [J]. Plast Reconstr Surg,1999,103(2):465-472.
[109]Yusuke Yamamoto, Hiroyuki Sakurai, Hiroaki Nakazawa, et al. Effect of vascular augmentation on the haemodynamics and survival area in a rat abdominal perforator flap model [J]. J Plast Reconstr Aesthet Surg,2009, 62(2):244-249.
[110]Geoffrey G. Hallock, and David C. Rice. Efficacy of Venous Supercharging of the Deep Inferior Epigastric Perforator Flap in a Rat Model [J]. Plast Reconstr Surg,2005,116(2):552-555.
[111]Hak Chang, Kyung Won Minn, Nobuaki Imanishi, et al. Effect of Venous Superdrainage on a Four-Territory Skin Flap Survival in Rats [J]. Plast Reconstr Surg,2007,119(7):2046-2051.
[112]Stell PM. The pig as an experimental model for skin flap behaviour a reappraisal of previous studies [J]. Br J Plast Surg,1977,30(1):1-8.
[113]Sullivan TP, Eaglstein WH, Davis SC, et al. The pig as a model for human wound healing [J]. Wound Repair Regen,2001,9(2):66-76.
[114]Zhong A, Pang CY, Sheffied WD, et al. Augmentation of acute random pattern skin flap viability in the pig [J]. J Surg Res,1992, 52(2):177-183.
[115]Massey MF, Gupata DK. The effects of systemic phenylephrine and epinephrine on pedicle artery and microvascular perfusion in a pig model of myoadipocutaneous rotational flaps [J]. Plast Reconstr Surg,2007, 120(5):1289-1299.
[116]Kerrigan CL. Zelt RG, Thomson JG, et al. The pig as an experimental animal in plastic surgery research for the study of skin flaps, myocutaneous flaps and fasciocutaneous flaps [J]. Lab Anim Sci,1986, 36(4):408-412.
[117]Jin Mei, ZhiXun Yin, Ji Zhang, et al. A mini pig model for visualization of perforator flap by using angiography and MIMICS [J]. Surg Radiol Anat,2009,14(published online).
[118]Daniel RK, Kerrigan CL. The omnipotential pig buttock flap [J]. Plast Reconstr Surg,1982,70(1):11-16.
[119]Haughey BH, Panje WR. A porcine model for multiple musculocutaneous flaps [J]. Laryngoscope,1989,99(2):204-212.
[120]Dor ion D, Boyed JB, Pang CY. Augmentation of transmidline skin perfusion and viability in transverse rectus abdominis myocutaneous (TRAM) flaps in the pig [J]. Plast Reconstr Surg,1991,88(4):642-649.
[121]Cederna PS, Chang P, Pittet Cuenod BM, et al. The Effect of Epigastric Vessel Ligation on the Vascular Territories of Epigastric Vessel Ligation on the Vascular Territories of the pig Rectus Muscle [J]. Plast Reconstr Surg,1997,99(1):194-205.
[122]Taylor GI, Watterson PA, Zelt RG. The vascular anatomy of the anterior abdominal wall:The basis for flap design [J]. Perspect in Plast Surg,1991,5(1):1-30.
[123]Kaufman T, Hunwitz DJ, Boehnke M, et al. The microsirculatory pattern of the transverse-abdominal flap:A cross-sectional Xerographic and CT scanning study [J]. Ann Plast Surg,1985,14(4):340-345.
[124]Gottfried W, Thomas S, Thomas B, et al. Venous Superdrainage in Deep Inferior Epigastric Perforator Flap Breast Reconstruction [J]. Plast Reconstr Surg,2001,109(1):162-166.
[125]Hamdi M, Weiler-Mithoff, DM, and Webster MIIC. Deep inferior epigastric perforator flap in breast reconstruction:Experience with the first 50 flaps [J]. Plast Reconstr Surg,1999,103(1):86-95.
[126]Wechselberger G, Schoeller T, Bauer T, et al. Venous superdrainage in deep inferior epigastric perforator flap breast reconstruction [J]. Plast Reconstr Surg,2001,108(1):162-166.
[127]Blondeel P N. One hundred free DIEP flap breast reconstructions: A personal experience [J]. Br J Plast Surg,1999,52(2):104-111,
[128]Nakayama Y, Soeda S, Kasai Y. The importance of arterial inflow in the distal side of a flap:an experimental investigation [J]. Plast
Reconstr Surg,1982,69(1):61-67.
[129]Ueda K, Harashina T, Oba S, et al. Which vessel is more important in the supercharged flap:artery, vein, or both? An experimental study [J]. J Reconstr Microsurg,1994,10(3):153-155.
[130]Roberts AP, Cohen JI, Cook TA. The rat ventral island flap:a comparison of the effects of reduction in arterial inflow and venous outflow [J]. Plast Reconstr Surg,1996,97(3):610-615.
[131]Miyamoto Shimpei, Minabe Toshiharu, HariiKiyonori. Effect of Recipient Arterial Blood Inflow on Free Flap Survival Area [J]. Plast Reconstr Surg,2008,121(2):505-513.
[132]Smith, P. J. The importance of venous drainage in axial pattern flaps in pigs [J]. Br J Plast Surg,1978,31(3):233-237.
[133]Fujino T. Contribution of the axial and perforator vasculature to circulation in flaps [J]. Plast Reconstr Surg,1967,39(2):125.
[134]Niranjan NS, Khandwala AR, Mackenzie DM. Venous augmentation of the free TRAM flap [J]. Br J Plast Surg,2001,54(4):335-337.
[135]Hallock GG, and Rice DC. Comparison of TRAM and DIEP flap physiology in a ratmodel [J]. Plast Reconstr Surg,2004,114(5):1179-1184.
[136]Cheng H, Luo Q, Liu Q, et al. Laser specie imaging of blood flow in microcirculation [J]. Phys Med Biol,2004,49(7):1347-1357.
[137]JD Briers. Laser Doppler, speckle and related techniques for blood perfusion mapping and imaging [J]. Physiol Meas,2001,22:R35.
[138]Kroll SS, Schusterman MA, Reece GP, et al. Timing of pedicle thrombosis and flap loss after free-tissue transfer [J]. Plast Reconstr Surg,1996,98(7):1230-1283.
[139]Hauge EM, Balling E, Hartmund T, et al. Secondary ischemia caused by venous or arterial occlusion shows differential effects on myocutaneous island flap survival and muscle ATP levels [J]. Plast Reconstr Surg,1997,99(3):825-833.
[140]Kerrigan CL, Wizman P, Hjortdal VE, et al. Global flap ischemia: A comparison of arterial versus venous etiology [J]. Plast Reconstr Surg, 1994,93(7):1485-1485.
[141]Yuen JC, and Feng Z. Monitoring free flaps using the laser Doppler flowmeter:Five-year experience [J]. Plast Reconstr Surg,2000,105(1): 55-61.
[142]Heller L, Levin LS, and Klitzman B. Laser Doppler flowmeter monitoring of free-tissue transfers:Blood flow in normal and complicated cases [J]. Plast Reconstr Surg,2001,107(7):1739-1745.
[143]Mailaender P, Machens HG, Waurick R, et al. Routine monitoring in patients with free tissue transfer by laser-Doppler flowmetry [J]. Microsurgery,1994,15(3):196-202.
[144]Fischer JC, Parker PM, and Shaw WW. Waveform analysis applied to laser Doppler flowmetry [J]. Microsurgery,1986,7(2):67-71.
[145]Hudson DA, Engelbrecht G, and Duminy FJ. Another method to prevent venous thrombosis in microsurgery:An in situ venous catheter [J]. Plast Reconstr Surg,2000,105(3):999-1003.
[146]Moon VH. Disturbance of circulation [A]. In:Anderson W, editor. Pathology [M]. St. Louis:The C.V. Mosby Company,1953:92.
[147]Rooks MD, Gould JS, Masear V, et al. Effects of venous hypertension on rabbit free flap survival [J]. Microsurgery,1991,12(4):253-261.
[148]Sakurai, Hiroyuki, Nozaki, et al. Monitoring the Changes in Intraparenchymatous Venous Pressure to Ascertain Flap Viability [J]. Plast Reconstr Surg,2007,119(7):2111-2117.
[149]Gregory TL, Aaron KR, Peter Herman, et al. Capillary blood gas:A novel means of assessing free flap perfusion in an animal model [J]. Otolaryngology-Head and Neck Surgery,2008,139(2):250-255.
[150]Harrison AM, Lynch JM, Dean JM, et al. Comparison of simultaneously obtained arterial and capillary blood gases in pediatric intensive care unit patients [J]. Crit Care Med,1997,25(11):1904-1908.
[151]Yildizdas D, Yapicioglu H. Yilmaz HL, et al. Correlation of simultaneously obtained capillary, venous, and arterial blood gases of patients in a paediatric intensive care unit [J]. Arch Dis Child,2004, 89:176-80.
[152]Liss AG, Liss P. Use of a modified oxygen microelectrode and laserDoppler flowmetry to monitor changes in oxygen tension and microcirculation in a flap [J]. Plast Reconstr Surg,2000,105(6): 2072-2078.
[153]Pryor SG, Moore EJ, Kasperbauer JL. Implantable Doppler flow system: experience with 24 microvascular free-flap operations [J]. Otolaryngol Head Neck Surg,2006,135(5):714-718.
[154]Raskin DJ, Erk Y, Spira M, et al. Tissue pll monitoring in microsurgery:a preliminary evaluation of continuous tissue pH monitoring as an indicator of perfusion disturbances in microvascular free flaps [J]. Ann Plast Surg,1983,119(4):331-339.
[155]Warner KG, Durham-Smith G, Butler MD, et al. Comparative response of muscle and subcutaneous tissue pH during arterial and venous occlusion in musculocutaneous flaps [J]. Ann Plast Surg,1989,22(2):108-116.
[156]Hofer SO, van der Kleij AJ, Grundeman PF, et al. Continuous tissue oxygenation assessment during bloodflow alterations in an isolated hindlimb model of the pig [J]. Adv Exp Med Biol,1994,345:693-700.
[157]Hirigoyen MB, Blackwell KE, Zhang WX, et al. Continuous tissue oxygen tension measurement as a monitor of free-flap viability [J]. Plast Reconstr Surg,1997,99(3):763-773.
[158]Tuominen HP, Asko-Seljavaara S, Svartling NE, et al. Cutaneous blood flow in the TRAM flap [J]. Br J Plast Surg,1992,45(4):261-269.
[159]Tuominen HP, Asko-Seljavaara S, Svartling NE. Cutaneous blood flow in the free TRAM flap [J]. Br J Plast Surg,1993,46(8):665-669.
[160]Finseth F, Cutting C. An experimental neurovascular island skin flap for the study of the delay phenomenon [J]. Plast Reconstr Surg,1978, 61(3):412-420.
[161]Zachary LS, Heggers JP, Robson MC, et al. Combined prostacyclin and thromboxane synthetase inhibitor UK 38485 in flap survival [J]. Ann Plast Surg,1986,17(2):112-115.
[162]Carramenha e Costa MA, Carriquiry C, Vasconez LO, et al. An anatomic study of the venous drainage of the transverse rectus abdominis musculocutaneous flap [J]. Plast Reconstr Surg,1987,79(2):208-208.
[163]Taylor GI, Caddy CM, Watterson PA, et al. The venous territories (venosomes) of the human body:Experimental study and clinical implications [J]. Plast Reconstr Surg,1990,86(2):185-185.
[164]Villafane 0, Gahankari D, Webster M. Superficial inferior epigastric vein (SIEV):'lifeboat'for DIEP/TRAM flaps [J]. Br J Plast Surg,1999,52:597-601.
[165]Imanishi N, Nakajima H, Minabe T, et al. Anatomical relationship between arteries and veins in the paraumbilical region [J]. Br J Plast Surg,2003,56(6):552-556.
[166]Holmstrom H. The free abdominoplasty flap and its use in breast reconstruction [J]. Scand J Plast Reconstr Surg,1979,13(3):423-427.
[167]Kroll SS. Free tram flap breast reconstruction after skin-sparing mastectomy [J]. Oper Tech Plast Surg,1999,6(1):22-26.
[168]Kroll SS, Gherardini G, Martin JE, et al. Fat necrosis in free and pedicled TRAM flaps [J]. Plast Reconstr Surg,1998,102(5):1502-7.
[169]Beckenstein MS, Grotting JC. Breast reconstruction with free-tissue transfer [J]. Plast Reconstr Surg,2001,108(5):1345-53.
[170]Marzia S, Liliana BA, Marcella S, et al. Needing a large DIEAP flap for unilateral breast reconstruction:Double-pedicle flap and unipedicle flap additional venous discharge [J]. Microsurgery,2010,30(2): 111-117.
[171]Blondeel PN, Boeckx WD. Refinements in free flap breast reconstruction:the free bilateral deep inferior epigastric perforator flap anastomosed to the internal mammary artery [J]. Br J Plast Surg,1994, 47(7):495-501.
[172]Blondeel PN, Van Landuyt KH, Montres SJ. Surgical-technical aspects of the free DIEP flap for breast reconstruction [J]. Oper Tech Plast Surg, 1999,6(1):27-37.
[172]Kroll SS. Free TRAM of DIEP flap:which to choose [J]. Oper Tech Plast Surg,1999,6(1):83-85.
[173]Lee JW, Lee YC, Chang TW. et al. Microvascularly augmented transverse rectus abdominis myocutaneous flap for breast reconstruction-reappraisal of its value through clinical outcome assessment and intraoperative blood gas analysis [J]. Microsurg,2008, 28(8):656-662.