Vascularized lymph node flaps can survive on venous blood without an arterial inflow: an experimental model describing the dynamics of venous flow using indocyanine green angiography (With video)

Ke Li; Fabio Nicoli; Chunxiao Cui; Yan Wo; Ning Fei Liu; Shaoqing Feng; Wenjing Xi; Peiru Min; Yixin Zhang

doi:10.1093/burnst/tkad019

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Vascularized lymph node flaps can survive on venous blood without an arterial inflow: an experimental model describing the dynamics of venous flow using indocyanine green angiography (With video)

更新时间：2023-08-29

- Vascularized lymph node flaps can survive on venous blood without an arterial inflow: an experimental model describing the dynamics of venous flow using indocyanine green angiography (With video)
- Burns & Trauma Vol. 11, Issue 1, (2023)
- 作者机构：
  
  1. Department of Plastic and Reconstructive Surgery
  2. Shanghai JiaoTong University School of Medicine
  3. Translational and Clinical Research Institute, Newcastle University
  4. Department of Plastic and Reconstructive Surgery, University of Rome “Tor Vergata”,999016
  5. Department of Plastic and Reconstructive Surgery, Northumbria NHS Trust
  6. Department of Facial Plastic and Reconstructive Surgery
  7. Fudan University
  8. Department of Anatomy and Physiology
  9. Shanghai Jiao Tong University
- 作者简介：
- 基金信息：
- DOI：10.1093/burnst/tkad019
  CLC：
- Published：2023，
  
  Published Online：19 July 2023，
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Ke Li, Fabio Nicoli, Chunxiao Cui, Yan Wo, Ning Fei Liu, Shaoqing Feng, Wenjing Xi, Peiru Min, Yixin Zhang, Vascularized lymph node flaps can survive on venous blood without an arterial inflow: an experimental model describing the dynamics of venous flow using indocyanine green angiography (With video), Burns & Trauma, Volume 11, 2023, tkad019, https://doi.org/10.1093/burnst/tkad019
DOI：

Ke Li, Fabio Nicoli, Chunxiao Cui, Yan Wo, Ning Fei Liu, Shaoqing Feng, Wenjing Xi, Peiru Min, Yixin Zhang, Vascularized lymph node flaps can survive on venous blood without an arterial inflow: an experimental model describing the dynamics of venous flow using indocyanine green angiography (With video), Burns & Trauma, Volume 11, 2023, tkad019, https://doi.org/10.1093/burnst/tkad019 DOI：

摘要

Abstract

BackgroundSeveral surgeons have described studies of free-tissue transfers using veins instead of arteries. These innovative microsurgical techniques can offer several advantages

such as an easier dissection during flap harvesting

and represent an alternative during an accidental surgical mistake or development of new surgical procedures. The purpose of this study was to describe and explore different constructs of vascularized lymph node transfer (VLNT) only based on venous blood flow in a mouse model

evaluate their blood flow microcirculation through indocyanine green (ICG) angiography and investigate the lymphatic drainage function and the lymph nodes’ structures.MethodsFive types of venous lymph node flaps (LNF) were created and investigated: Types IA

IIA and IIB were developed by ICG intraoperatively (with videos in the article). Seven weeks later

by applying methylene blue

the recanalization of the lymphatic vessels between the LNF and the recipient site was detected. Lymph nodes were collected at the same time and their structures were analyzed by hematoxylin and eosin staining analysis.ResultsAll of the venous LNFs developed except Type IC. Seven weeks later

methylene blue flowed into Types IA

IIA and IIB from recipient sites. When comparing with arteriovenous lymph node

the medullary sinus was diffusely distributed in venous lymph nodes. The proportion of cells was significantly reduced (p < 0.05). The artery diameters were significantly smaller (p < 0.05). The veins diameters and lymphatic vessels output in Types IA

IIA and IIB were more dilated (p < 0.05).ConclusionsThis research demonstrated that Type IA

IIA and IIB venous LNFs can retrogradely receive venous blood supply; they can survive

produce a lymphatic recanalization and integrate with the surrounding tissue

despite lymph node structural changes. Our results will improve the understanding of the survival mechanism of venous LNFs and will help researchers to design new studies or lymphatic models and eventually find an alternative procedure for the surgical treatment of lymphedema.

关键词

Keywords

Vein circulationVenousLymph nodeFlapVascularized lymph node flapLymphedemaIndocyanine green

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