Assessing the pressure at zero flow in canine epigastric skin flaps

The pressure at zero flow was examined using three independent techniques in island epigastric skin flaps in dogs under sodium pentobarbital anesthesia. (i) The flap was perfused from a reservoir which was varied in height to supply a range of pressures. The corresponding flows were measured by electromagnetic blood flowmetry and the pressure at zero flow was determined by extrapolation to zero flow. (ii) Arterial inflows as low as 2.2 microL/min were delivered by a Harvard pump and corresponding pressures were measured. The pressure at zero flow was determined by inspection. (iii) The artery supplying the flap was occluded with a microclip and the plateau following the decay of pressure was read as the pressure at zero flow. The pressure decay technique was the simplest, most reproducible method and was verified by the other two methods. It gave a pressure at zero flow of 5.8 +/- 0.4 mmHg (0.77 +/- 0.05 kPa). The critical closing pressure is discussed and related to the pressure at zero flow.