Comparing the Time-Dependent Evolution of Microcirculation in Gracilis vs. ALT Flaps Using Laser-Doppler Flowmetry and Tissue-Spectrometry

Journal of Clinical Medicine

Paul I. Heidekrueger¹  Konstantin Frank²  Denis Ehrl²  Nicholas Moellhoff²  Svenja Pistek²  Riccardo E. Giunta²  Verena Alt² 

[1] Centre of Plastic, Aesthetic, Hand and Reconstructive Surgery, University of Regensburg, 93053 Regensburg, Germany;Division of Hand, Plastic and Aesthetic Surgery, University Hospital, Ludwig Maximilian University of Munich, 81377 Munich, Germany;

关键词: microvascular flow;    O2C;    anastomosis;    free flap;    microsurgery;   

DOI  :  10.3390/jcm11092425

来源: DOAJ

【 摘 要 】

Postoperative free flap monitoring is considered a key component of care after microsurgical reconstruction. To achieve successful flap salvage after surgical revision, early recognition of vascular compromise is required. The aim of this study was to assess and compare the time-dependent evolution of microcirculation in gracilis muscle (GM) and anterolateral thigh (ALT) flaps. This study included continuous measurements of blood flow (flow), hemoglobin oxygenation (SO₂) and the relative amount of hemoglobin (rHb) using laser-doppler flowmetry and tissue-spectrometry (O2C, LEA Medizintechnik, Gießen, Germany) over a time-period of 72 h. Microcirculation was assessed in a total of 66 viable free flaps (GM n = 40; ALT n = 26). A statistically significant positive correlation between time post-anastomosis and microvascular flow was found for both GM and ALT flaps with r_s = 0.384 (p < 0.001) and r_s = 0.178 (p = 0.015), respectively. No significant positive or negative correlations between time post-anastomosis and SO₂ were found for both GM and ALT flaps with r_s = 0.052 (p = 0.387) and r_s = −0.018 (p = 0.805), respectively. Overall, a significant negative correlation between time post-anastomosis and rHb was found for GM flaps with r_s = −0.140 (p = 0.019). For ALT flaps, no significant positive or negative correlation was found with r_s = −0.011 (p = 0.887). Microcirculation differs in different flap entities, and surgeons should be aware of these differences in order to correctly evaluate and classify the values of flow, SO₂ and rHb obtained when using the O2C device for postoperative monitoring.

【 授权许可】

Unknown