Serial fluorometric assessment of experimental neurovascular island flaps

Quantification of tissue sodium fluorescein delivery was used to monitor neurovascular island flaps subjected to various manipulations of the vascular pedicle. In 20 anesthetized rats, inferior epigastric neurovascular island flaps were studied during transient arterial or venous occlusion and presumed vascular spasm. During clamping, there was no substantial fluorescein uptake by the flaps. Reinjection of fluorescein after removal of the clamps resulted in adequate fluorescein uptake and elimination in those flaps that remained viable. Three of the flaps with presumed vascular spasm eventually evidenced an increase in fluorescence with subsequent injections and remained viable; one flap did not show adequate fluorescence after any of the four injections and subsequently necrosed. It is concluded that documentation of tissue fluorescein delivery following serial injections of dye permits accurate monitoring of the functional status of the vascular pedicle at close-time intervals during the critical hours immediately after flap construction.