OBJECTIVE: To study the availability of transplantation of anterolateral femoral skin flap with absence of the first branch of musculocutaneous artery. METHODS: One hundred and sixty cases of anterolateral femoral skin flap transplantation in the past 15 years were reviewed, to investigate the relationship between the outcome of the transplantation and the types, distribution, original point, diameter of blood vessels. Among the 160 cases, there were 10 cases, 6.3% in total, of skin flap transplantation with the pedicle of high site direct cutaneous femoral artery, ranging from 10 cm x 14 cm to 12 cm x 18 cm in size, applied to repair soft tissue defect. RESULTS: There were 149 cases, among the 160 cases, survived and all the 10 cases of femoral skin flap transplantation with high site anterolateral cutaneous artery survived. CONCLUSION: The femoral skin flap with high site anterolateral cutaneous artery has good blood supply, larger size available, and easier operation. When the first branch of descending anterolateral femoral artery is absent, the femoral skin flap with high site anterolateral cutaneous artery is an optimal alternative.
摘要:目的:探讨表达吲哚胺2,3二氧化酶(IDO)的KC对同种异体小鼠移植皮片存活时间的影响及其机制。方法:构建BABL/c →C57BL/6的皮肤移植模型,分别于移植术后第2、7、14天输注KC,于移植术后第7天每组各取2只皮瓣行HE染色和TUNEL以检测淋巴细胞浸润和凋亡情况。KaplanMeier对数秩检验对各组进行生存分析。结果:输入表达IDO和FasL的KC能明显延长BABL/c →C57BL/6皮肤移植模型中皮肤移植物的存活时间,1－甲基色氨酸能阻断此效应。IFNγ组皮瓣浸润淋巴细胞的凋亡率较高(Plt;0.05)。结论:表达IDO和FasL的KC在体内能明显延长同种异体小鼠皮片的存活时间,IDO在KC维持外周免疫耐受中发挥重要作用。Abstract: Objective: To investigate kupffer cells(KC) expressing indoleamine 2,3dioxygenase(IDO) on the survival of grafted skin in mouse and its underlying mechanism. Methods: BABL/c skin was transplanted to C57BL/6. Donor KC were injected i.v. at days 2,7, 14 before transplantation. HE and TUNELAP were used to identify infiltrating cells and apoptotic cells in section of skin allografts from 7 days posttransplantation respectively. The survival rate of recipients among groups were analyzed by Logrank test. Results: Injection of KC expressing IDO and FasL from BABL/c mice into C57BL/6 could prolong a skin graft survival from the donor, but 1methyltryptophan could block the effect in vivo. The apoptosis rate of lymphocyte among skin graft in IFNγ group is more than other group(Plt;0.05). Conclusion: IDO and FasLexpressing KC from the donor of mouse can significantly prolong the skin graft survival. IDO may play an important role in KC to induce immune tolerance.