Autonomization of epigastric flaps in rats

Mücke, Thomas; Borgmann, Anna; Wagenpfeil, Stefan; Günzinger, Ralf; Nöbauer, Christian; Lange, Rüdiger; Slotta‐Huspenina, Julia; Hölzle, Frank; Wolff, Klaus‐Dietrich

doi:10.1002/micr.20892

Cited by 25 publications

(16 citation statements)

References 32 publications

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“…In experimental studies, early signs of capillary blood flow were found in delayed random pattern skin flaps 3–4 days after surgery, and the survival rate of ischemic flaps was increased with local injections of vascular endothelial growth factor 21–24. In a recent experimental study by Mücke et al, it was shown that epigastric flaps in rats develop a 62% necrosis when ligating the pedicle after 3 days, whereas after 5 days, the flaps have almost healed completely 25…”

Section: Discussionmentioning

confidence: 99%

Autonomization of free flaps in the oral cavity: A prospective clinical study

et al. 2012

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Controversy exists over how long a free flap is dependent on its pedicle and if neovascularization is different between flap types, recipient sites, and irradiated and nonirradiated patients. An understanding of the timing of this process should optimize the safety of secondary procedures involving the flap. In a prospective clinical study, hemoglobin oxygenation and capillary flow were measured in 50 flaps (25 forearm flaps, 15 osteocutaneous fibula flaps, and 10 anterolateral thigh flaps) 4 and 12 weeks postoperatively. The flaps were located at the floor of the mouth, cheek, or tongue (n = 39) or at the hard or soft palate (n = 11). Measurements were carried out using the O2C monitoring system under temporary digital occlusion of the pedicle. After 4 weeks, 17 free flaps were found to be autonomized indicated by the O2C measurements comparing both values before and after digital compression of the vascular pedicle. After 12 weeks, 41 patients had completion of free flap autonomization, as indicated by the HbO(2) and CF before and after pedicle compression. The location of free flap in the lower jaw (P < 0.0001 after 4 weeks, P = 0.013 after 12 weeks), fasciocutaneous radial forearm flaps after 4 weeks (P < 0.0001), and not irradiated recipient site after 4 weeks (P = 0.014) were found to be positive factors significantly influencing autonomization. In conclusion, free flap autonomization depends on several variables which should be considered before further surgery after free flap reconstruction as the transferred tissue can be still dependent on its pedicle.

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Section: Discussionmentioning

confidence: 99%

Autonomization of free flaps in the oral cavity: A prospective clinical study

et al. 2012

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“…The used method in this study (Oxygen to See, O2C, Lea Medizintechnik, Germany) combines lightguide tissue spectrophotometry and laser Doppler flowmetry. Both methods were used separately in a large number of human, and animal studies . The O2C device allows measurements of blood flow (flow) and blood velocity using Doppler flowmetry.…”

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confidence: 99%

Evaluation of a non‐invasive monitoring method for free flap breast reconstruction using laser doppler flowmetrie and tissue spectrophotometry

Rothenberger¹,

Amr²,

Schaller³

et al. 2013

Microsurgery

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Background: Despite advances in the monitoring of free flaps, there is still a demand for new technology to detect ischemic complications at an early stage. The aim of the present study was to evaluate the reliability of the O2C-device in terms of detecting flap failure in commonly used perforator flaps for breast reconstruction. Methods: A total of 34 patients undergoing breast reconstruction were involved in this study. The perfusion dynamics of 23 deep inferior epigastric perforator flaps and 11 superior gluteal arterial perforator flaps were assessed using the O2C-device, which combines a laser light, to determine blood flow (flow), velocity, and white light to determine hemoglobin oxygenation (SO 2 ) and relative amount of hemoglobin (rHB). Measurements were carried out intra-operatively after clamping and declamping the perforator vessels. In the post-operative period measurements were carried out every hour for the first 48 hours and from 3rd to 7th for every 2 hours. These dates were compared to findings of clinical assessment. Results: Several intra-operative measurements, during the clamping and declamping the different perforator vessels, revealed a high correlation for all parameters: Flow (r 5 0.89, P < 0. 05), Velo (r 5 0.92, P < 0. 05), SO 2 (r 50.84, P <0. 05), and rHB (r 50.83 P < 0.05). Vessel occlusion was detected in five cases, of which three were due to arterial thrombosis and two further cases were due to venous occlusion. Of the five cases, one flap loss caused by venous occlusion was noted. Conclusion: The O2C-device seems to be a reliable, objective, and non-invasive device for the monitoring of free flaps. Thus, it may improve flap survival rates by detecting vascular compromise at an early stage. V V C 2013 Wiley Periodicals, Inc. Microsurgery 33: 350-357, 2013.

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“…On the other hand, clinical reports describe complete flap survival despite early disruption of the pedicle (Chen et al, 2002;Salgado et al, 2002;Wolff et al, 2003Wolff et al, , 2009Wise et al, 2011); this has also been shown in experimental work (Civelek et al, 2009;Mucke et al, 2011). In all three patients, 10e13 days of extracorporeal perfusion were sufficient for bone and muscle tissue, but not for the large skin paddle in patient 1.…”

Section: Discussionmentioning

confidence: 65%