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Correlation of viability and laser Doppler flowmetry in ischemic flaps
K R Knight1, P A Collopy, B M O'Brien
1Microsurgery Research Centre, St. Vincent's Hospital, Melbourne, Victoria, Australia.
The Journal of Surgical Research
|November 1, 1987
Summary
Laser Doppler flowmetry can predict flap survival. Measuring microvascular blood flow in ischemic flaps accurately determines viability, even before physical changes are apparent.
Area of Science:
- Biomedical Engineering
- Surgical Research
- Vascular Biology
Background:
- Assessing flap viability is crucial in reconstructive surgery.
- Early detection of microcirculatory compromise can improve outcomes.
- Ischemic damage to flaps can lead to partial or complete failure.
Purpose of the Study:
- To evaluate the predictive value of microvascular blood flow measurements for flap survival.
- To correlate laser Doppler flowmetry readings with flap viability after ischemia.
- To determine if blood flow changes precede visible signs of flap failure.
Main Methods:
- Microvascular blood flow was measured using laser Doppler flowmetry in rabbit epigastric island flaps.
- Flaps were subjected to 6.5-hour or 17.5-hour ischemia at 37°C.
- Contralateral non-ischemic flaps served as controls.
- Flap survival was assessed at 7 days postoperatively.
Main Results:
- Flaps with 6.5-hour ischemia had 69% survival; 17.5-hour ischemia resulted in 0% survival.
- Post-ischemia, blood flow was reduced but normalized in surviving flaps.
- Failed flaps showed initial sluggish flow that decreased to zero within 4 days.
- Microcirculatory failure was detected by flowmetry before visible changes.
Conclusions:
- Percentage of ischemic flap flow relative to control flow reliably predicts flap viability at 7 days.
- Laser Doppler flowmetry is a sensitive tool for early detection of microcirculatory compromise.
- This method allows for timely intervention to potentially salvage compromised flaps.