A study of perfusion of the distal free-TRAM flap using laser Doppler flowmetry.
The aim of this study was to characterise microcirculatory changes in the distal part of a flap and to evaluate whether measurement of the microcirculation may predict flap complications (FC). In this prospective study, 30 patients undergoing a delayed breast reconstruction were included. Perioperative data were recorded and with the laser Doppler flowmetry (LDF; Perimed) blood flow was recorded in the central part (zone I) and the distal part (zone IV) of the flap. A lower blood flow was observed in zone IV of patients with flap complications compared to patients without flap complications (P=0.013). In addition, LDF demonstrated different flow trends in zone I compared to zone IV indicating a delayed opening of the choke vessels connecting the angiosomes in the distal part of the flap. The LDF has proven to be a useful investigative tool to monitor microcirculatory changes. In future studies it will be used to evaluate interventions aimed at decreasing distal ischaemia and reducing flap complications.
Booi
Darren I
DI
Maastricht University Hospital, Department of Plastic, Reconstructive and Hand Surgery, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands. darrenbooi@gmail.com
Debats
Iris B J G
IB
Boeckx
Willy D
WD
van der Hulst
Rene R W J
RR
D000328:Adult; D005260:Female; D006801:Humans; D007511:Ischemia / Q000175:diagnosis; D017078:Laser-Doppler Flowmetry / Q000379:methods; D016462:Mammaplasty / Q000379:methods*; D008833:Microcirculation; D008875:Middle Aged; D019990:Perioperative Care / Q000379:methods; D011183:Postoperative Complications / Q000175:diagnosis; D011379:Prognosis; D011446:Prospective Studies; D012039:Regional Blood Flow; D012307:Risk Factors; D012881:Skin Temperature; D013524:Surgical Flaps / Q000098:blood supply*