Isotope perfusion and infrared thermography of arterialised, venous flow-through and pedicled venous flaps.
In an experimental study on the epigastric venous system of rats, we examined three types of venous flaps with regard to their perfusion and long-term results: arterialised venous flaps, flow-through venous flaps and venous island flaps. We documented afferent and efferent blood flow with radiolabelled substances and blood distribution with infrared thermography. By measuring the surviving flap surfaces after 4 months, the relative success rate for each flap type was determined. The results show that in the chosen model the entire surface of the arterialised venous flap had a survival rate of 92.7%, the flow-through venous flap 62.4%, and the venous island flap about 31%. The venous island flaps had the worst distribution of intravenously injected 125J-Fibrinogen, and it was significantly worse in all types of venous flaps than in standard epigastric flaps; moreover, the clearance of intracutaneously injected 99mTc was the lowest in venous island flaps. The infrared thermographic study showed that the blood in the arterialised venous flaps dispersed faster and over a larger area than in flow-through venous and island flaps. Given these results, we conclude that arterialised venous flaps are the safest form of venous flaps, whereas venous island flaps carry a high risk of partial or total necrosis.
Wolff
K D
KD
Department of Maxillofacial Plastic Surgery, Steglitz Medical Center, Free University of Berlin, Germany.
Telzrow
T
T
Rudolph
K H
KH
Franke
J
J
Wartenberg
E
E
D000818:Animals; D005340:Fibrinogen; D006085:Graft Survival; D008297:Male; D009336:Necrosis; D011184:Postoperative Period; D051381:Rats; D017208:Rats, Wistar; D012039:Regional Blood Flow; D012867:Skin / Q000098:blood supply* / Q000473:pathology; D013670:Sodium Pertechnetate Tc 99m; D013524:Surgical Flaps / Q000473:pathology; D013817:Thermography
D005340:Fibrinogen; D013670:Sodium Pertechnetate Tc 99m