Dermofluorometric prediction of flap survival

Techniques to predict flap survival would help the reconstructive surgeon, but while various modalities exist, none is consistently accurate. The standard clinical method of fluorescein visualization by ultraviolet light requires such a high dose that it precludes rapid repetition. Recently, assessment of cutaneous fluorescein with the dermofluorometer has allowed mini-dose fluorescein, quantification, and repetition. The fiberoptic dermofluorometer was tested on experimental and clinical flaps. An experiment was devised to determine if the dermofluorometer could accurately predict flap survival. Modified McFarlane flaps were raised in 10 250- to 300-g female Sprague-Dawley rats and divided into 10 1-cm grids. A dermoviability index was calculated for each grid. A reading below 30% correlated with flap necrosis. Our clinical experiences were less predictive.