ID 106359
著者
柏木, 圭介 Department of Plastic and Reconstructive Surgery, the University of Tokushima Graduate School
橋本, 一郎 Department of Plastic and Reconstructive Surgery, the University of Tokushima Graduate School 徳島大学 教育研究者総覧 KAKEN研究者をさがす
安倍, 吉郎 Department of Plastic and Reconstructive Surgery, the University of Tokushima Graduate School 徳島大学 教育研究者総覧 KAKEN研究者をさがす
コウツ, クニオ Department of Plastic and Reconstructive Surgery, the University of Tokushima Graduate School
ヤマノ, マサヒロ Department of Plastic and Reconstructive Surgery, the University of Tokushima Graduate School
中西, 秀樹 Department of Plastic and Reconstructive Surgery, the University of Tokushima Graduate School 徳島大学 教育研究者総覧 KAKEN研究者をさがす
キーワード
leech therapy
congestion
island flap
microcirculation
TcPO2 and TcPCO2 monitoring
資料タイプ
学術雑誌論文
抄録
Background A congested flap is a good indication for leech therapy. However, determining the appropriate number of leeches as well as the appropriate application time in clinical cases is difficult. We analyzed hemodynamics in rabbit island flaps under leech therapy to find a suitable clinical procedure for determining the appropriate number of leeches to be used and the duration of therapy. Methods Island flaps were raised in 35 rabbit ears, and congestion was induced by venous clamping. Treatment involved use of 1 or 3 leeches and was begun 60 minutes after venous occlusion. Flaps were examined for area of surviving tissue, alterations in transcutaneous oxygen and carbon dioxide tension (TcPO2 and TcPCO2), and flow volume. Arteriole and venule diameters and flow velocities were examined microscopically. Results Flap survival area in the 3-leech therapy group was significantly larger than the 1-leech therapy group and the control group. With 3- leech therapy, TcPCO2 decreased significantly, as did arteriole and venule diameters. After clamp release, TcPCO2 and venule diameter continued to decrease in this group, and flow velocity increased significantly. Conclusions Leech therapy may salvage compromised flaps by replacing congested blood with new arterial blood and thus maintaining flap viability. TcPO2 and TcPCO2 monitoring may help evaluate the therapeutic effect and determine the appropriate number of leeches to apply and the duration of therapy.
掲載誌名
The journal of medical investigation : JMI
ISSN
13431420
cat書誌ID
AA11166929
60
3-4
開始ページ
213
終了ページ
220
並び順
213
発行日
2013-08
EDB ID
出版社版DOI
出版社版URL
フルテキストファイル
言語
eng
著者版フラグ
出版社版
部局
医学系