Comparative Study of Small Vessel (under 0.8 mm) Anastomosed Free Flap and Larger Vessel (over 0.8 mm) Anastomosed Free Flap: Does Supermicrosurgery Provide Sufficient Blood Flow to the Free Flap?

Abstract

Background: This study aimed to quantify the blood flow of free flaps and compare the blood flow of small-vessel (<0.8 mm) and larger-vessel (>0.8 mm) anastomosed free flaps. Methods: A retrospective study included the patients treated with a perforator free flap which was successful in the lower extremity were included between June 2015 and March 2017. A color duplex ultrasound system measured flow volume through the pedicle by analyzing the mean flow peak velocity, flow volume, and flow volume per 100g of the flap. Results: A total of 69 patients were enrolled in this study. There was no statistical difference in peak velocity comparing the small vessel anastomosed free flap (25.2 ± 5.6) and the larger vessel anastomosed free flap (26.5 ± 5.4). Flow volume (6.8 ± 4.2 versus 6.3 ±3.6) and flow volume/100g (3.6 ± 3.9 versus 6.2 ± 6.9) also did not show significant differences. Conclusions: Small-vessel (<0.8 mm) free flaps showed similar flow velocity and flow volume to larger-vessel (>0.8 mm) anastomosed free flaps. Blood flow to the small-vessel anastomosed free flap was sufficient despite its small-vessel size.