[Increasing the survival rate of endangered free microvascular tissue transplants using a prostacyclin derivative]

Free flap transplantations and replantations of extremities are threatened by venous occlusion due to haematomas, contusions, and secondary healing of the surrounding tissues. In an experimental investigation in 18 Sprague-Dawley-rats, the influence of the Prostacyclin analogue Iloprost on temporary ischemia by venous occlusion was tested. Free groin flaps were transplanted to the neck of these animals with microanastomoses of the nutrient superficial epigastric vessels to the carotid artery and the jugular vein. On the first postoperative day the vein was temporarily clamped. In the control group there was always a total loss of the flap by haemorrhagic necrosis. The intraarterial flap perfusion by Iloprost was able to diminish the effects of the secondary ischemia. In some cases shortly after the perfusion and always on the next day, positive oxygen pressures were measurable. 80% of the flaps survived.