J Reconstr Microsurg 2001; 17(3): 163-168
DOI: 10.1055/s-2001-14347
Copyright © 2001 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Evaluation of Blood Flow in Free Microvascular Flaps

Fulvio Lorenzetti1,2 , Sinikka Suominen1 , Erkki Tukiainen1 , Hannu Kuokkanen1 , Erkki Suominen1 , Jyrki Vuola1 , Sirpa Asko-Seljavaara1
  • 1Department of Plastic Surgery, Helsinki University Hospital, Finland
  • 2Department of Plastic Surgery, Cisanello Hospital, Pisa, Italy
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Publication History

Publication Date:
31 December 2001 (online)


Free flap surgery is routine today, yet little is known of its pathophysiology. In this study, the authors evaluated the hemodynamics in different types of free microvascular flaps, by measuring intraoperative transit-time flow. Eighty-six free transplants-21 free TRAM flaps for breast reconstruction, 18 radial forearm flaps for head and neck reconstructions, and 47 muscle flaps for head and neck, trunk and lower extremity reconstructions-were studied. Donor artery flow was highest in the radial artery (mean: 57.5 ± 50 (SD) ml/min) but dropped (p < 0.001) to one tenth (6.1 ± 2 ml/min) after anastomosis. The flow was lowest (4.9 ± 3 ml/min) in the recipient artery of the TRAM flap but, after anastomosis, increased significantly (13.7 ± 5 ml/min) to the level of the flow in the donor artery. The donor-artery flow in muscle flaps had a mean of 15.9 ± 11 ml/min, and it significantly increased after anastomosing (23.9 ± 12 ml/min). Weight-related intake of blood was highest in the radial forearm flap (18.5 ± 6 ml/ min/100g) and lowest in the TRAM flap (2.5 ± 1 ml/min/100g).

The study showed that blood flow through a free microvascular flap does not depend on recipient artery flow. Even low-flow arteries can be used as recipients, because the flow increases according to free-flap requirements. The blood flow through a free microvascular flap depends on the specific tissue components of the flap.