Changes in blood velocity following microvascular free tissue transfer.
Understanding how pedicle blood velocities change after free tissue transfer may enable microvascular surgeons to predict when thrombosis is most likely to occur. A 20-MHz Doppler probe was used to measure arterial and venous blood velocities prior to pedicle division and 20 minutes after anastomosis in 32 microvascular free flaps. An implantable Doppler probe was then used to measure arterial and venous blood velocities daily for 5 days. Peak arterial blood velocity averaged 30.6 cm/s prior to pedicle division and increased to 36.5 cm/s 20 minutes after anastomosis ( P < 0.05). Peak venous blood velocity averaged 7.6 cm/s prior to pedicle division and increased to 12.4 cm/s 20 minutes after anastomosis ( P < 0.05). Peak arterial blood velocities averaged 34.0, 37.7, 43.8, 37.9, 37.6 cm/s on postoperative days (PODs) 1 through 5, respectively. Peak venous blood velocities averaged 11.9, 14.5, 18.2, 16.8, 17.7 cm/s on PODs 1 through 5, respectively. The peak arterial blood velocity on POD 3, and peak venous blood velocities on PODs 2, 3, and 5 were significantly higher than 20 minutes after anastomosis ( P < 0.05). Arterial and venous blood velocities increase for the first 3 postoperative days, potentially contributing to the declining risk for pedicle thrombosis during this time period.
Hanasono
Matthew M
MM
Department of Plastic Surgery, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA. mhanasono@mdanderson.org
Ogunleye
Olubunmi
O
Yang
Justin S
JS
Hartley
Craig J
CJ
Miller
Michael J
MJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical; D001783:Blood Flow Velocity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control; D011184:Postoperative Period; D013524:Surgical Flaps / Q000098:blood supply*; D013927:Thrombosis / Q000517:prevention & control; D018608:Ultrasonography, Doppler; D055815:Young Adult