Alteration of arterial blood flow after free muscle transfer.
To investigate blood flow alterations and their determinants after free flap transfer, we focused on a vascularized latissimus dorsi muscle segment for reconstruction of the paralyzed face as an ideal model, since the vascular pedicle and type of flap are identical among patients. Seventeen patients were studied using color Doppler ultrasonography at 6 time points from before the operation to >1 month postoperatively. The influences of preoperative facial arterial flow volume, volume of muscle, and duration of ischemia on postoperative pedicle arterial flow were analyzed. Arterial flow volume decreased dramatically after revascularization and remained constantly low in comparison with preoperative blood flow volume. The shape of the blood velocity waveform reflecting downstream vascular impedance changed, but recovered to the baseline state within 6 days. Preoperative flow volume and transferred muscle weight correlate with postoperative flow volume for 6 days postoperatively. The duration of ischemia was not influential.
Department of Plastic Surgery, Kyorin University School of Medicine, Tokyo, Japan. masakazukurita@aol.com
Masakazu
M
Kurita
Akihiko
A
Takushima
Tomohiro
T
Shiraishi
Mutsumi
M
Okazaki
Mine
M
Ozaki
Kiyonori
K
Harii
D000293:Adolescent; D000328:Adult; D000368:Aged; D001158:Arteries / Q000000981:diagnostic imaging*; D005145:Face / Q000098:blood supply*; D005158:Facial Paralysis / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000098:blood supply; D019651:Plastic Surgery Procedures; D013524:Surgical Flaps / Q000098:blood supply*; D018615:Ultrasonography, Doppler, Color; D055815:Young Adult