Intra and postoperative evaluations of microcirculation and micro-rheological parameters in a rat model of musculocutaneous flap ischemia-reperfusion.
OBJECTIVE
To examine how the ischemia-reperfusion injury of latissimus dorsi-cutaneous maximus (LDCM) musculocutaneous flap affects the microcirculatory (flap's skin surface) and hemorheological parameters, and whether an intraoperative deterioration would predictively suggest flap failure in the postoperative period.


METHODS
Ten healthy male rats were subjected to the study. In Group I the left flap was sutured back after 2-hour, while the contralateral side was right after its elevation. In Group II the same technique was applied, but the pedicle of the left flap was atraumatically clamped for 2-hour. The contralateral side was left intact. On the flap skin surface laser Doppler tissue flowmetry measurements were done before and after and during the protocols applied in the groups. Microcirculatory and hemorheological examinations were done postoperatively.


RESULTS
The microcirculatory parameters significantly decreased during immobilization and ischemia. Afterwards, all the regions showed normalization. In the retrospective analysis there was a prominent difference between the microcirculatory parameters of necrotic and survived flap during the early postoperative days (1-3) in Group II. Erythrocyte aggregation and deformability showed only slight differences.


CONCLUSIONS
Two-hour ischemia and reperfusion caused deterioration in latissimus dorsi-cutaneous maximus flap microcirculation. Predicting the possible postoperative complication, the intraoperative laser Doppler measurement can be informative.
Institute of Surgery, Faculty of Medicine, University of Debrecen, HU.
Zoltan
Z
Klarik
Department of Plastic and Burn Surgery, Medical Centre, Hungarian Defense Forces, Budapest, HU.
Robert
R
Tamas
Faculty of Medicine, University of Debrecen, HU.
Eniko
E
Toth
Faculty of Medicine, University of Debrecen, HU.
Ferenc
F
Kiss
Faculty of Medicine, University of Debrecen, HU.
Eva L
EL
Kovacs
Medical Centre, Hungarian Defense Forces, Budapest, HU.
Marta
M
Jäckel
Faculty of Medicine, University of Debrecen, HU.
Istvan
I
Furka
Faculty of Medicine, University of Debrecen, HU.
Norbert
N
Nemeth
D000818:Animals; D062109:Dermatologic Surgical Procedures; D004195:Disease Models, Animal; D018056:Hemorheology / Q000502:physiology*; D007432:Intraoperative Period; D017078:Laser-Doppler Flowmetry; D008297:Male; D008833:Microcirculation / Q000502:physiology*; D064827:Myocutaneous Flap / Q000098:blood supply* / Q000473:pathology; D011184:Postoperative Period; D011897:Random Allocation; D051381:Rats; D015427:Reperfusion Injury / Q000503:physiopathology*; D012867:Skin / Q000098:blood supply* / Q000473:pathology; D016038:Skin Transplantation / Q000379:methods; D064171:Superficial Back Muscles / Q000098:blood supply* / Q000473:pathology; D013997:Time Factors