An experimental study on the application of arterialization of the vein in treating extensive degloving injury of the skin

Abstract

Objective To investigate the influence on the survival of extensively degloved skin by increasing perfusion via venous arterialization.Methods Extensive degloving injury model was created by making 3.3:1 distal-based skin avulsion in 20 rear legs of 10 healthy Japanese white rabbits.The legs of each rabbit were randomly assigned as the experimental side and control side.On the experimental side,nutrition vessels from the posterior tibial artery and vein were severed and the proximal artery was anastomosed to the distal vein.Both the greater and lesser saphenous veins were anastomosed.On the control side only the greater and lesser saphenous veins were anastomosed.Results On the experimental side 60.2％ of the degloved skin survived,while 50.5％ of the degloved skin survived on the control side.The difference was statistically significant (P ＜ 0.05).Skin contraction was 26.9％ on the experimental side and 31.9％ on the control side,the difference not being significant (P ＞ 0.05).Blood gas analysis of groin veins was 41.32 mmHg on the control side and 60.35 mmHg on the experimental side for venous blood PaO2.The difference was statistically significant (P ＜ 0.05).Conclusion Arterialization of the vein can augment blood perfusion of degloved skin and increase skin survival.However,as a non-physiological blood circulation,it also promotes blood congestion,tissue swelling and fibrosis of the degloved skin. Key words: Models, animal; Microsurgery; Degloving injury of skin; Arterialization