title: Perfusion and Oxygenation of Random Advancement Skin Flaps Depend More on the Length and Thickness of the Flap Than on the Width to Length Ratio.
abstract: OBJECTIVE
  The aim was to investigate the relationship between the dimensions (length, width, and thickness) of random advancement skin flaps and retained tissue perfusion and oxygenation.
  
  
  METHODS
  Flaps were raised on the flanks of pigs. The flaps were either 0.5 or 1.0 cm wide, thin (dissected halfway through the subcutaneous tissue) or thick (dissected down to the muscle fascia). Tissue perfusion was measured by laser Doppler velocimetry, and tissue oxygenation (pO2) was measured using a Licox system, every 0.5 cm along the flaps' length. Tissue temperature was visualized by high-resolution infrared camera.
  
  
  RESULTS
  Perfusion and oxygenation decreased gradually from the base to the tip of the flap, reaching approximately 40% of presurgical values (2.0 cm) and approximately 20% (2.5 cm) from the base of the flap. There was virtually no blood flow, nor oxygen tension, 3.0 cm from the base of the flap. The width to length ratio of the flap did not determine blood flow or oxygenation, being approximately 30% in a 0.5 cm wide and 2 cm long flap, and 0% in a 1.0 cm wide and 4 cm long flap, both with a width to length ratio of 1:4. Blood flow and oxygenation were preserved to a greater extent in the thick flaps (∼40%) than in the thin flaps (∼20%), in a 0.5 cm wide and 2 cm long flap.
  
  
  CONCLUSIONS
  The dissection of a random advancement flap results in hypoperfusion and oxygenation that cannot be predicted by the width to length ratio but depend on the length and thickness of the flap.
authors.affiliation: Department of Ophthalmology, Clinical Sciences, Lund University and Skåne University Hospital, Sweden.
authors.forename: Khashayar
authors.initials: K
authors.lastname: Memarzadeh
authors.affiliation: Department of Ophthalmology, Clinical Sciences, Lund University and Skåne University Hospital, Sweden.
authors.forename: Rafi
authors.initials: R
authors.lastname: Sheikh
authors.affiliation: Department of Ophthalmology, Clinical Sciences, Lund University and Skåne University Hospital, Sweden.
authors.forename: Jonas
authors.initials: J
authors.lastname: Blohmé
authors.affiliation: Department of Ophthalmology, Clinical Sciences, Lund University and Skåne University Hospital, Sweden; Department of Urology, Clinical Sciences, Lund University and Skåne University Hospital, Sweden.
authors.forename: Christian
authors.initials: C
authors.lastname: Torbrand
authors.affiliation: Department of Ophthalmology, Clinical Sciences, Lund University and Skåne University Hospital, Sweden.
authors.forename: Malin
authors.initials: M
authors.lastname: Malmsjö
keywords: blood flow; experimental; oxygenation; perfusion; random flaps