[Monitoring of microcirculation of pedicle skin flaps and early division of their pedicles].
In experimental study, microcirculation in 7 human pedicle skin flaps was monitored continuously by laser Doppler flowmetry (LDF), skin thermometer, and clinical tests. The changes of the microcirculation in flap were divided into three phases: rapid rising (1-4 days after operation); plateau (4-7 days after operation); and slow rising (7 days after operation). The plateau stage was considered as the "critical" period. Early division of the flap within the plateau and the slow rising causes flap survival (100%). In clinical application, we put forward the following objective criteria of early division of pedicle skin flap. The value (PU) of LDF monitoring the flap returned to the preoperative level. The value (PU) returned to or exceeded 50% of that (PU) determined before application of the tourniquet. The skin temperature value between before and after application of the tourniquet was less than 1 degree C. The targets of clinical test showed no significant changes beyond 1 hour with the tourniquet. The time of division was decreased to 6-8 postoperative days in our clinical application.
Yang
X
X
Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Beijing.
D000293:Adolescent; D000328:Adult; D002648:Child; D002921:Cicatrix / Q000601:surgery*; D006801:Humans; D017078:Laser-Doppler Flowmetry; D008833:Microcirculation; D012867:Skin / Q000098:blood supply*; D012881:Skin Temperature; D013524:Surgical Flaps / Q000379:methods