Effects of Tissue Component Volumes on Vascular Resistance in Free Flaps.
BackgroundA successful free flap transfer is achieved, in part, by having a thorough understanding of vascular anatomy and blood flow dynamics. We previously reported that vascular resistance differs by type of free flap. To test the hypothesis that the difference reflects the proportion of tissue components within free flaps, we calculated blood flow and vascular resistance for free flaps in which we determined the volume of each tissue component.MethodsMeasurements and calculations were made for 40 free flap transfers performed at our hospital: 7 radial forearm flaps, 14 anterolateral thigh flaps, and 19 rectus abdominis myocutaneous flaps.ResultsThe vascular resistance of free flaps was inversely related to the volume of each tissue component. Univariate regression analysis revealed that muscle volume correlated most closely with resistance (r= 0.881), followed by skin (r= 0.622), and fat (r= 0.577). Multiple regression analysis confirmed the relationship between combined muscle and fat volume and resistance (R2= 0.865).ConclusionsA strong inverse correlation exists between vascular resistance and combined muscle and fat tissue volume in flaps. It may be helpful to consider these relationships when making decisions regarding choice of free flap and recipient vessels.
Department of Plastic and Reconstructive Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Masashi
M
Ono
Department of Plastic and Reconstructive Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Keisuke
K
Takanari
Department of Plastic and Reconstructive Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Kazuhiro
K
Toriyama
Department of Plastic and Reconstructive Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Shunjiro
S
Yagi
Department of Plastic and Reconstructive Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Katsumi
K
Ebisawa
Department of Plastic and Reconstructive Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Hisashi
H
Sawamura
Department of Plastic and Reconstructive Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Miki
M
Kambe
Division of Biostatistics, Center for Advanced Medicine and Clinical Research, Nagoya University Hospital, Nagoya, Japan.
Kenta
K
Murotani
Department of Plastic and Reconstructive Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Yuzuru
Y
Kamei
D000293:Adolescent; D000328:Adult; D000368:Aged; D001783:Blood Flow Velocity / Q000502:physiology*; D002648:Child; D005260:Female; D005542:Forearm; D058752:Free Tissue Flaps / Q000098:blood supply*; D006085:Graft Survival / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal; D019651:Plastic Surgery Procedures / Q000379:methods*; D017568:Rectus Abdominis; D012039:Regional Blood Flow / Q000502:physiology; D012189:Retrospective Studies; D017695:Soft Tissue Injuries / Q000601:surgery*; D013848:Thigh; D014655:Vascular Resistance / Q000502:physiology*; D014945:Wound Healing; D055815:Young Adult