CAUSES OF SURGICAL IMPLICATIONS AFTER AUTOTRANSPLANTATION OF AXIAL FASCIOCUTANEOUS FLAP AND WAYS TO PREVENT COMPLICATIONS (EXPERIMENTAL-CLINICAL EXAMINATION) 2

The article presents an analysis of the peculiarities of vascular wall regeneration in the area of the microvascular suture, vascular reactions occurring in the skin of the free skin-fascial epigastric flap of white rats after its autotrans- plantation are described, the main causes of the destruction of flaps and the ways of their prevention are indicated. It was shown that the complete restoration of the endothelial lining in the wall of the arterial vessel after performing the microvascular suture occurs by 7 days, in the wall of the venous vessel - by 10 days. In the uncomplicated course of the postoperative period, peripheral revascularization of the free epigastric flap and its integration into the recipi- ent bed results from strictly defined vascular responses: I - period of vascular spasm of the axial vessels of the flap (1-3 days); II - the period of pronounced dilatation of the axial vessels of the flap (4-14 days). The first signs of the formation of vascular bonds with surrounding tissues are observed by the 7th day and are completed on the 14th day. The engraftment ends with the formation of a normotrophic cutaneous scar. Among the main causes of vascu- lar complications after autotransplantation of free epigastric flaps are violations of the blood supply to the wall of venous vessels, as well as hemodynamic disorders caused by primary ischemia, denervation of the vascular bed of flaps, capillary hypoperfusion, interstitial edema and haemoconcentration in the venous bed.

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