Method for experimental grafting of solid free skin flap. RU patent 2513249.

FIELD: medicine.

SUBSTANCE: solid free skin flap 1.5 cm is formed in a rat. A fascia covering a wound surface is excised, and a subjacent muscle is exposed on an existing bed. The flap is fixed to a skin border along the opposite borders. Free skin borders are sutured together. After 8-9 days, the skin borders fused above the flap are separated and brought apart.

EFFECT: method provides the optimal conditions of the skin flap engraftment, enables a full contact to the subjacent tissues, improves the development of the microvasculature using no angiogenesis stimulants.

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The invention relates to medicine, namely to the experimental Transplantology. The method can be used as a model autotransplantation of the skin flap.

It is considered that the skin flap transplantation in experimental animals, in particular in rats could be a useful model to study in the experiment of some fundamental problems of Transplantology. To perform experiments on rats convenient, because rats are fit animals endure various types of anesthesia and manipulation and therefore, when working with them, the results can be replicated and subjected to statistical analysis.

For the development and application of new methods of increasing the efficiency of healing skin allografts needed a way in which, in most cases, reliable engraftment autograft skin. In other words, the optimal method of transplantation of the skin flap, developed on the autotransplants, can be transferred to allotransplantation skin flaps. This researcher will be able to deal with the problems of establishing the foreign material, abstracting from the technique of transplantation.

From the literature it follows that engraftment solid free pornoslonik skin grafts in rats, even autotransplants, it is not always and reaches only 37.5-41,6% (Dry, Sigachev, Soustruhy. Dynamics of blood flow in the autotransplants skin on different parts of the body in rats, according to laser Doppler flowmetry. Methodology flowmetry, Issue 5, 2001, str-196). Low percentage of engraftment autotransplants skin in rats does not allow to use these animals for simulation of allotransplantation skin and implementation of objective evaluation of the effectiveness of healing of skin on the new proposed methods.

Main condition of successful engraftment pornoslonik autotransplants skin is to restore in them adequate nutrition (oxygenation and metabolism) due to the rapid recovery of microcirculation and the subsequent incarceration of new blood vessels from vascular networks muscular-fascial bed. Full recovery of microcirculation in the skin graft depends primarily from reliable immobilization it to the surface of the wound bed promoting capillarization transplant (Radostina A.I., Mushenko So, Minute S. The microcirculation in the auto and allotransplantation skin in white rats. Cardiovascular system in clinic and experiment. Collection of scientific works. The Peoples Friendship University named. Patrice Lumumba. - M, 1984, - Pp.93-95).

As a prototype of the selected method of transplantation solid free full-thickness autologous skin flap with dimensions of 2.5 x 2.5 cm in rats, involving immobilization of transplant to wound surface with nodal joints, and also application of adhesive plaster for 5 days and the introduction of retabolil, inducing additional anabolic processes and capillarization transplant (A.A. ZADOROZHNY, HE Strigol, S.I. Kataev. The impact of retabolil and application of adhesive tape on engraftment and volumetric blood flow autotransplants skin on different parts of the body in rats. Methodology flowmetry, Issue 6, 2002 str-142).

The method allows to increase the percentage of engraftment pornoslonik skin grafts from 41.6% to 66.6% at imposing nodal joints and 87.5% of the combined application of seams, plaster and retabolil.

This method does not provide a hundred percent survival rate of the flap, which does not allow to create reliable fixation of the flap to the wound surface, to restore adequate food in it, and requires additional use of drugs common actions before and after transplantation to stimulate angiogenesis.

Thus, today a reliable and reproducible method autotransplantation skin flap rats with a high percentage of engraftment (close to 100%) the use of drugs common actions in experimental transplantation is missing.

The present invention is to create a reproducible way autotransplantation solid free full-thickness skin graft in rats, which can be used as a cell-based model.

Technical result achieved in the implementation of the invention consists in providing reliable cutaneous flap acceptance by the creation of adequate conditions diffuse power tissues autograft by excluding clamping his microvessels and surrounding tissues while maintaining reliable fixation in the field of the bed; and easier and cheaper way through exceptions additional use of drugs common actions promoting angiogenesis.

We empirically selected dimensions of transplant, as well as an original double fixation transplant in the tissues, which allows, on the one hand, to provide the most complete contact the transplant with the underlying tissues, and on the other hand, to improve the diffusion food in it at the stage of development of microcirculation and avoid ischemic damage is a leading factor of exclusion.

Absence of necessity of application of pharmaceuticals not only simplifies and reduces the cost of the way, but also allows you to explore the true engraftment of allografts, be influenced by immunopharmacological drugs on the tolerance of the body for the transplant.

Summary of the invention consists in the following.

For transplantation solid free full-thickness autologous skin flap in the experiment form a continuous free full-layer skin flap in rats. Place it on the same couch and fix it. If this form of skin flap of round shape with maximum 1.5 see Excised the fascia covering the wound surface, with an exposure of the underlying muscles or muscle. Fixation carry out on opposite edges of the flap, gripping the flap edge and edge skin adjacent to it. Then close the flap by linkage between the free edges of the skin adjacent to the flap. In 8-9 days sever and bred in hand accreted over the flap edge of the skin, exposing it.

In the particular case of skin flap is formed on the back in the chest.

Fixation of each of the other edge of the flap can be executed at one point.

Fixing the opposite edge of the flap can be performed by suturing, which is removed after 15-20 days.

Before closing flap his wound irrigate solution antibiotic, as a solution of antibiotic use of 0.4% solution gentamycin sulfate in physiological solution.

The method is as follows.

Immobilizes and conduct General anesthesia animal - rat. Back in the chest remove hair by plucking and subsequent shaving of the residues safe hair with a razor that is treated the operating field 70% ethanol solution.

Avoiding strong compression, produce capture skin clip with annular shape the industry. Cut the skin flap with a scalpel or a blade safety razors held surgical clip, producing a cut along the contour of the branch. The flap should be the round form with the largest size (diameter) of 1.5, see

Cut the skin flap is put on a sterile cotton pad soaked 0.4% solution of gentamicin in physiological solution. After stopping bleeding in the wound and allocate excised the fascia back, covering the wound surface. The flap is put on naked muscle groups. Fixation of the flap perform suturing on opposite edges, grasping the edge of the skin flap and the edge of the skin adjacent to the flap. Then close the flap by linkage between the free edges of the skin adjacent to it. Before closing flap his wound irrigate solution of the antibiotic. As a solution of antibiotic use of 0.4% solution gentamycin sulfate in physiological solution.

After the operation is finished on the wound put ointment levomecol, cover with a sterile cloth and put circular bandage.

In 8-9 days bandage removed. Remove sutures, sever and bred in hand accreted over the flap edge of the skin, exposing it.

Seams that fix the location of the skin flap in two opposite points removed after 15-20 days.

To prove the possibility of implementing the stated purpose and achievements of the technical result, the following data.

The proposed method of transplantation of solid free-full-thickness autologous skin flap was tested on 14 breed rats Wistar and 5 rats breed August. Transplantirovannam skin flap has taken root in all 19 animals that participated in the experiment.

Finally under control and conduct a General anaesthesia rat rocks Wistar weighing 410 g veterinary drug Soleil, which was administered subcutaneously at a dose of 12 mg To suppress the aggressive behavior of the animal was previously narcotizirutego ethyl ether in a desiccator. The duration of anesthesia was 1 hour and 20 minutes.

On a photo 1 shows the operating field on the back in the chest. It was prepared by the removal of hair by plucking and subsequent shaving of the residues safe hair with a razor. Treated the operating field 70% ethanol solution.

Pictures 2, 3, 4 and 5 demonstrate cutting the skin flap and autologous transplantation, who carried out the following way.

Avoiding strong compression, made a grip skin clip with annular shape the industry. Cut the skin flap with a scalpel. Got flap of round shape with maximum 1.5 see Carved skin flap was placed in a sterile cotton pad soaked 0.4% solution of gentamicin in physiological solution. After stopping bleeding in the wound isikli the fascia back, covering the wound surface. Flap imposed on naked muscle groups. Fixation of the flap fulfilled suturing on the opposite, the most remote from each other edges, grasping the edge of the skin flap and the edge of the skin adjacent to the flap. Fixation of each of the other edge of the flap performed at one point. Then he closed the flap by linkage between the free edges of the skin adjacent to it. Before closing flap his wound watered the solution of the antibiotic. As a solution antibiotic used 0.4% solution gentamycin sulfate in physiological solution.

Picture 6 shows the removal of the bandage that is produced in 8-9 days after transplantation.

On photo 7 shows the wound and skin flap in it after the stitches have been removed, release and breeding in hand accreted over the flap edge of the skin in 8-9 days after transplantation.

Seams that fix the location of the skin flap in two opposite points, took off after 15-20 days.

Pictures 8A and 8b show engraftment autograft skin two rats at 25 days after transplantation.

Thus, the method allows to achieve 100% engraftment autograft additional use of drugs of General jurisdiction, accelerating angiogenesis.

Reduction of the area of transplant in conditions of double fixation allows to reach the most complete contact with the underlying tissues and improving the diffusion of power in the development phase of microcirculation in the transplant and avoid it ischemic damage.

No need to use pharmaceuticals allows you to explore the true engraftment of allografts and influence with immunopharm drugs on the tolerance of the body for the transplant.

1. Method of transplantation of solid free-full-thickness autologous skin flap in the experiment, including the formation of solid free-full-thickness skin graft in rats, placing it on the same couch, and fixing it, wherein form a skin flap of round shape with maximum 1.5 cm, excised the fascia covering the wound surface, with nudity subject muscle or muscle, and the documentation carry out on opposite edges of the flap, gripping the flap edge and edge of the skin adjacent to the flap; then close the flap by linkage between the free edges of the skin adjacent to it; in 8-9 days sever and bred in hand accreted over the edge flap skin, exposing it.

2. The method according to claim 1, wherein the skin flap is formed on the back in the chest.

3. The method according to claim 1, wherein the fixation of each of the other edge of the flap perform at one point.

4. The method according to claim 1, wherein the fixation opposite edge of the flap is performed by suturing.

5. The method according to claim 4, wherein the seams, fixing opposite edges, remove after 15-20 days.

6. The method according to claim 1, characterized in that before the closing flap his wound irrigate solution of the antibiotic.

7. The method of claim 6, wherein the solution of antibiotic use of 0.4% solution gentamycin sulfate in physiological solution.