Cargando…

Cross-sectional Vascularization Pattern of the Adipofascial Anterolateral Thigh Flap for Application in Tissue-engineered Bone Grafts

As part of the engineering of bone grafts, wrapping constructs in well-vascularized tissue, such as fascial flaps, improves bone formation. Our aim was to understand the cross-sectional vascularization pattern of human adipofascial flaps for this application. METHODS: Seven adipofascial anterolatera...

Descripción completa

Detalles Bibliográficos
Autores principales: Buergin, Joel, Werth, Lucas, Largo, René, Scherberich, Arnaud, Schaefer, Dirk J., Kaempfen, Alexandre
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8865508/
https://www.ncbi.nlm.nih.gov/pubmed/35223345
http://dx.doi.org/10.1097/GOX.0000000000004136
_version_ 1784655647188451328
author Buergin, Joel
Werth, Lucas
Largo, René
Scherberich, Arnaud
Schaefer, Dirk J.
Kaempfen, Alexandre
author_facet Buergin, Joel
Werth, Lucas
Largo, René
Scherberich, Arnaud
Schaefer, Dirk J.
Kaempfen, Alexandre
author_sort Buergin, Joel
collection PubMed
description As part of the engineering of bone grafts, wrapping constructs in well-vascularized tissue, such as fascial flaps, improves bone formation. Our aim was to understand the cross-sectional vascularization pattern of human adipofascial flaps for this application. METHODS: Seven adipofascial anterolateral thigh (ALT) flaps were harvested from five human cadaveric specimens. Axial vessel density was analyzed by immunohistochemistry and quantitative histology. RESULTS: We found a high density of blood vessels directly superficial to and close to the fascia. A secondary plexus in between this first suprafascial plexus and the subdermal plexus was also identified. In all specimens, this second plexus showed less vascular density, and appeared to be at a constant level within the suprafascial fat throughout the flaps. The peak measurements for this secondary plexus varied between 1.2 and 2 mm above the deep fascia, depending on the donor’s body mass index. CONCLUSIONS: Quantitative immunohistochemistry is a reliable method to quantify and locate vessel density in an adipofascial flap. This is vital information before wrapping nonvascularized material into such a flap to estimate the inosculation potential of these vessels and likelihood of survival of the tissue. To profit from both suprafascial vascular plexuses, a correlation between subcutaneous tissue thickness and distance of the second plexus to the fascia should be further investigated. For the moment, we recommend maintaining at least 2–3 mm of subcutaneous fatty tissue on the fascia, to profit from both plexuses. Engineered constructs should be wrapped on the superficial medial side of the fascial flap to enhance vascularization.
format Online
Article
Text
id pubmed-8865508
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Lippincott Williams & Wilkins
record_format MEDLINE/PubMed
spelling pubmed-88655082022-02-24 Cross-sectional Vascularization Pattern of the Adipofascial Anterolateral Thigh Flap for Application in Tissue-engineered Bone Grafts Buergin, Joel Werth, Lucas Largo, René Scherberich, Arnaud Schaefer, Dirk J. Kaempfen, Alexandre Plast Reconstr Surg Glob Open Research As part of the engineering of bone grafts, wrapping constructs in well-vascularized tissue, such as fascial flaps, improves bone formation. Our aim was to understand the cross-sectional vascularization pattern of human adipofascial flaps for this application. METHODS: Seven adipofascial anterolateral thigh (ALT) flaps were harvested from five human cadaveric specimens. Axial vessel density was analyzed by immunohistochemistry and quantitative histology. RESULTS: We found a high density of blood vessels directly superficial to and close to the fascia. A secondary plexus in between this first suprafascial plexus and the subdermal plexus was also identified. In all specimens, this second plexus showed less vascular density, and appeared to be at a constant level within the suprafascial fat throughout the flaps. The peak measurements for this secondary plexus varied between 1.2 and 2 mm above the deep fascia, depending on the donor’s body mass index. CONCLUSIONS: Quantitative immunohistochemistry is a reliable method to quantify and locate vessel density in an adipofascial flap. This is vital information before wrapping nonvascularized material into such a flap to estimate the inosculation potential of these vessels and likelihood of survival of the tissue. To profit from both suprafascial vascular plexuses, a correlation between subcutaneous tissue thickness and distance of the second plexus to the fascia should be further investigated. For the moment, we recommend maintaining at least 2–3 mm of subcutaneous fatty tissue on the fascia, to profit from both plexuses. Engineered constructs should be wrapped on the superficial medial side of the fascial flap to enhance vascularization. Lippincott Williams & Wilkins 2022-02-22 /pmc/articles/PMC8865508/ /pubmed/35223345 http://dx.doi.org/10.1097/GOX.0000000000004136 Text en Copyright © 2022 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (https://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Research
Buergin, Joel
Werth, Lucas
Largo, René
Scherberich, Arnaud
Schaefer, Dirk J.
Kaempfen, Alexandre
Cross-sectional Vascularization Pattern of the Adipofascial Anterolateral Thigh Flap for Application in Tissue-engineered Bone Grafts
title Cross-sectional Vascularization Pattern of the Adipofascial Anterolateral Thigh Flap for Application in Tissue-engineered Bone Grafts
title_full Cross-sectional Vascularization Pattern of the Adipofascial Anterolateral Thigh Flap for Application in Tissue-engineered Bone Grafts
title_fullStr Cross-sectional Vascularization Pattern of the Adipofascial Anterolateral Thigh Flap for Application in Tissue-engineered Bone Grafts
title_full_unstemmed Cross-sectional Vascularization Pattern of the Adipofascial Anterolateral Thigh Flap for Application in Tissue-engineered Bone Grafts
title_short Cross-sectional Vascularization Pattern of the Adipofascial Anterolateral Thigh Flap for Application in Tissue-engineered Bone Grafts
title_sort cross-sectional vascularization pattern of the adipofascial anterolateral thigh flap for application in tissue-engineered bone grafts
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8865508/
https://www.ncbi.nlm.nih.gov/pubmed/35223345
http://dx.doi.org/10.1097/GOX.0000000000004136
work_keys_str_mv AT buerginjoel crosssectionalvascularizationpatternoftheadipofascialanterolateralthighflapforapplicationintissueengineeredbonegrafts
AT werthlucas crosssectionalvascularizationpatternoftheadipofascialanterolateralthighflapforapplicationintissueengineeredbonegrafts
AT largorene crosssectionalvascularizationpatternoftheadipofascialanterolateralthighflapforapplicationintissueengineeredbonegrafts
AT scherbericharnaud crosssectionalvascularizationpatternoftheadipofascialanterolateralthighflapforapplicationintissueengineeredbonegrafts
AT schaeferdirkj crosssectionalvascularizationpatternoftheadipofascialanterolateralthighflapforapplicationintissueengineeredbonegrafts
AT kaempfenalexandre crosssectionalvascularizationpatternoftheadipofascialanterolateralthighflapforapplicationintissueengineeredbonegrafts