Hemodynamic differences in blood flow between free skin and muscles flaps: prospective study

Area of Science:

• Vascular Surgery
• Medical Imaging
• Hemodynamics

Background:

• Postoperative hemodynamic assessment is crucial for flap survival.
• Doppler ultrasound is a non-invasive tool for evaluating blood flow.
• Understanding flap-specific blood flow changes is essential for surgical outcomes.

Purpose of the Study:

• To evaluate postoperative hemodynamic changes in skin and muscle flaps using Doppler ultrasound.
• To compare blood flow dynamics between skin and muscle flaps over a 12-month period.
• To identify factors influencing blood flow in flap recipient arteries.

Main Methods:

• Doppler ultrasound was used to measure minimum velocities, resistance indexes, and diameters.
• Measurements were taken intraoperatively and at multiple time points up to 12 months post-surgery.
• Skin (n=11) and muscle (n=4) flaps were analyzed, along with control arteries.

Main Results:

• Both skin and muscle flaps showed increased minimum velocities and blood flow immediately after transfer.
• Control arteries exhibited decreased values over the follow-up period.
• Recipient artery blood flow decreased over time in both flap types, starting at 10 days for skin and 1 month for muscle flaps. Larger muscle flaps resulted in significantly higher recipient artery blood flow compared to skin flaps.
• Resistance indexes were higher in skin flaps (99 ± 6) than in muscle flaps (89 ± 9).

Conclusions:

• Postoperative Doppler ultrasound demonstrates dynamic hemodynamic changes in flap vasculature.
• Blood flow in flap recipient arteries tends to decrease over time, necessitating monitoring.
• Flap size and type significantly influence postoperative blood flow, with larger muscle flaps promoting greater flow.