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Cutaneous blood flow in the TRAM flap
H P Tuominen1, S Asko-Seljavaara, N E Svartling
1Department of Plastic Surgery, Töölö Hospital, Helsinki University Central Hospital, Finland.
British Journal of Plastic Surgery
|May 1, 1992
Summary
Laser Doppler flowmetry and transcutaneous oxygen measurements reveal that reduced blood flow in TRAM flaps can predict skin necrosis after breast reconstruction. Monitoring these parameters is crucial for patient outcomes.
Area of Science:
- Plastic Surgery
- Vascular Surgery
- Biomedical Engineering
Background:
- The pedicled TRAM flap is a common technique for breast reconstruction.
- Assessing flap viability is critical to prevent complications like skin necrosis.
Purpose of the Study:
- To evaluate changes in cutaneous blood flow and oxygen tension in pedicled TRAM flaps.
- To determine if these measurements can predict the risk of skin necrosis.
Main Methods:
- Utilized laser Doppler flowmetry (LDF) and transcutaneous oxygen tension (ptcO2) in 14 patients undergoing TRAM flap breast reconstruction.
- Measured blood flow and oxygen levels at different stages, including post-dissection and after deep inferior epigastric artery ligation.
Main Results:
- Flap dissection led to increased LDF, while deep inferior epigastric artery ligation significantly decreased LDF and ptcO2.
- Eight patients experienced minor cutaneous necrosis, particularly on the random side.
- Low LDF and ptcO2 values post-ligation, along with a negative response to oxygen stimulation, predicted necrosis.
Conclusions:
- Cutaneous blood flow and oxygen tension are key indicators of TRAM flap viability.
- Monitoring LDF and ptcO2 can help identify patients at risk for skin necrosis, allowing for timely intervention.