Differences in Blood Flow Volume and Vascular Resistance between Free Flaps: Assessment in 58 Cases
21 October 2008 (online)
In free-flap transfer, blood flow in the transferred flap contributes to wound healing and to resistance against infection in the recipient site. Successful reconstructions using free tissue transfers may be required to define and choose flaps with abundant blood flow in necessary cases. We investigated blood flow in the flap by transit-time ultrasound flowmeter in 58 free-flap transfers. Flow volume was compared between flap tissues as vascular resistance in the flap was calculated. Fasciocutaneous and osteocutaneous flaps had relatively low blood flow volume, myocutaneous flaps had more, and intraperitoneal flaps had still higher blood flow volume. These differences were statistically significant. Vascular resistance significantly decreased in the same order of comparison. Our findings will help in selecting the most suitable flaps for reconstructive surgery.
Vascular resistance - blood flow - free flap
- 1 Heller L, Levin L S. Lower extremity microsurgical reconstruction. Plast Reconstr Surg. 2001; 108 1029-1041
- 2 Gosain A, Chang N, Mathes S, Hunt T K, Vasconez L. A study of the relationship between blood flow and bacterial inoculation in musculocutaneous and fasciocutaneous flaps. Plast Reconstr Surg. 1990; 86 1152-1162
- 3 Mahabir R C. Vascular resistance in human muscle flaps. Ann Plast Surg. 2001; 47 148-152
- 4 Warren J V, Gorlin R. Calculation of vascular resistance. Methods Med Res. 1958; 7 98-99
- 5 Goldberg J, Sepka R S, Perona B P, Pederson W C, Klitzman B. Laser Doppler blood flow measurements of common cutaneous donor sites for reconstructive surgery. Plast Reconstr Surg. 1990; 85 581-586
- 6 Sasmor M T, Reus W F, Straker D J, Colen L B. Vascular resistance considerations in free-tissue transfer. J Reconstr Microsurg. 1992; 8 195-200
- 7 Sesso H D, Stampfer M J, Rosner B et al.. Systolic and diastolic blood pressure, pulse pressure, and mean arterial pressure as predictors of cardiovascular disease risk in men. Hypertension. 2000; 36 801-807
- 8 McKee N H, Clarke H M, Nigra C A, Manktelow R T. A study of blood flow and pressure in the vessels supplying a free flap. Plast Reconstr Surg. 1982; 69 68-73
- 9 Ganong W F.
Dynamics of blood and lymph flow: cardiovascular regulatory mechanisms. In: Ganong WF Review of Medical Physiology. Stamford, CT; Appleton & Lange 1997: 537-566
- 10 Guyton A C.
Overview of the circulation, and medical physics of pressure, flow, and resistance: vascular distensibility and function of the arterial and venous system. In: Guyton AC, Hall JE Textbook of Medical Physiology. Philadelphia, PA; WB Saunders 1991: 150-158
- 11 Standring S.
Integrating cells into tissues: functional anatomy of the musculoskeletal system. In: Standring S Gray's Anatomy. 39th ed. Philadelphia, PA; Elsevier 2005: 29-133
- 12 Jeremiah C H.
Jejunum and ileum. In: Standring S Gray's Anatomy. 39th ed. Philadelphia, PA; Elsevier 2005: 1167-1172
Keisuke Takanari, M.D.
Department of Plastic and Reconstructive Surgery, Nagoya University Graduate School of Medicine
65 Turumai-cho, Showa-ku, Nagoya, Japan 466-8560