title: Monitoring tissue elimination of fluorescein with the perfusion fluorometer: a new method to assess capillary blood flow.
abstract: Visual assessment of tissue staining after intravenous fluorescein is a common technique for predicting viability of questionably perfused tissue. The development of the perfusion fluorometer has permitted quantification of tissue fluorescein, providing increased precision. This study employed this instrument to calculate fluorescein elimination from rats with and without raised dorsal pedicle flaps. Control animals exhibited homogeneous patterns of fluorescein elimination consistent with first-order kinetics. Elimination in experimental animals was assessed after the animals received full back skin flaps with the cephalad pedicle remaining intact. Three distinct patterns of elimination were noted in each flap. In the cephalad portion, elimination was similar to control. At the caudad end, no elimination was noted. Midflap, fluorescein was eliminated slowly. These elimination patterns predicted ultimate viability 14 days postoperatively, as they correspond to viable, dystrophic, and transitional sections, respectively (P less than 0.001). We conclude that perfusion fluorometry can assess capillary flow in healthy and ischemic tissue by documenting elimination as well as delivery of fluorescein.
mesh_terms: D000818:Animals; D001775:Blood Circulation; D005452:Fluoresceins / Q000378:metabolism*; D005470:Fluorometry / Q000295:instrumentation / Q000379:methods*; D007700:Kinetics; D008297:Male; D051381:Rats; D012867:Skin / Q000098:blood supply; D013524:Surgical Flaps
chemical_list: D005452:Fluoresceins