Functional Aspects of Free Muscle Transplantation: Atrophy Reinnervation, and Metabolism

Abstract

The atrophy, reinnervation, and metabolism of free muscle flaps were studied in a rat model, by syngeneic and orthotopic transplantation of abdominal wall muscle flaps with neurovascular anastomoses. The three parameters were examined at different time periods, using electrophysiologic and 31-P-spectroscopic measurements. Results show that a certain degree of atrophy (one-fifth of the original volume) must be expected, even when new axons grow throughout the nerve. This is explained by the early reduction of flap metabolism, leading to a loss of parenchyma until neuromuscular conduction is restored. As the maximum duration of ischemia is 2 hr, muscular damage due to reduced metabolism was not produced.

Preliminary Study of Temporal Change in Free Flap Volume after Tongue Reconstruction

“…One problem with the use of free flaps in reconstructing tongue is that the volume of the flap decreases over time 2,3,6,13) . It is believed that this decrease is due to fatty degeneration of the muscle-fat flap itself or fusion with adipose tissue 9) .…”

Functional and Aesthetic Reconstruction of the Defects Following the Hemiglossectomy in Patients with Oropharyngeal Cancer

“…On the other hand, the lingual root requires some voluminous reconstruction to prevent miss-swallowing or dysphagia. It has been reported that the transferred muscle flap more decrease its volume postoperatively because of the interruption of muscle innervation compared with an adiposal flap [12,13]. So we recommend that lingual root and retromandibular space should be reconstructed with adipo-cutaneous tissue, not muscle.…”

Postoperative Voluminal Flap Reduction After Fingertip Reconstruction Using the Reverse Digital Artery Island Flap

“…cases. [8][9][10][11] We suggest that accurate estimation of the appropriate volume for the flap is important for preventing donor site complications. Donor site complications such as skin scar formation, joint contracture, numbness or hypersensitivity of the elevated side of the flap in RDAIF have been reported.…”

“…To prevent flap congestion, six flaps were harvested together with a thin skin pedicle (case [11][12][13][14][15][16], and the other flaps had no skin pedicle. In many cases, skin grafts were applied to cover the tissue defect after harvesting the flap from the hypothenar (cases 2, 3), arch of a foot (5, 7), cubital fossa (8,9,11) and forearm (10,(12)(13)(14)(15)(16). The defect of case 1 was covered with a dorsal metacarpal artery flap, and relatively small defects (cases 4, 6) were sutured.…”