Laser Doppler flowmetry in the determination and evaluation of blood flow characteristics during the correction of cosmetic defects of abdominal wall

Abstract

The aim — to determine the possibility of using Laser Doppler flowmetry (LDF) for the study of blood flow in the vessels of the anterior abdominal wall in order to improve the results and develop new methods of treatment of patients with cosmetic defects of the anterior abdominal wall in patients with obesity I — II stage.Materials and methods. The study of blood flow on the anterior abdominal wall using LDF scan was performed in 132 patients, predominantly females 116 (87.9 %). The average age of patients was 43.4 ± 10.3 years. All patients had obesity of grade I or II. The average body mass index was 32.8 ± 2.7 kg/m2. The patients were divided into two groups: the main group — 64 (48.5 %) patients who underwent abdominoplasty in combination with other simultaneous operations and liposuction (lipoabdominoplasty), and the control group — 68 (51.5 %) patients who underwent abdominoplasty in combination with other simultaneous operations without liposuction. The mean duration of the operation in the main group was 255.3 ± 23.5 min., in the control group — 210.2 ± 21.2 min. Patients were examined in the preoperative period according to the standards of the Ministry of Health of Ukraine. LDF was performed before and during surgery and within 10 days of the postoperative period to determine the microcirculation indices (MI) of the anterior abdominal wall.Results and discussion. The study of MI in the control and main groups prior to the treatment, no statistically significant difference was found between the groups (p = 0.83). Immediately after the operation, the relationship between low‑frequency rhythms, which characterize the active mechanism of microcirculation, and high‑frequency and heart rhythms is disrupted. Normally, the amplitude of vasomotions is 20 — 25 % of the level of the LDF signal, immediately after the operation it decreases to 46 — 55 % at an oscillatiofrequency of 6 — 8 per minute. The average period of recovery of MI to the initial level is 8 days, the maximum is 11 days (for a smoker with type 2 diabetes). A decrease in the level of microcirculation within 1 — 2 days after surgery was 5.2 % bigger in the liposuction group than in the control group. There was no statistically significant difference between the groups in the dynamics of changes in MI during the study period (p = 0.767).Conclusions. The study showed that during lipoabdominoplasty there is no critical reduction in the microcirculation in the flaps compared to the classical abdominoplasty. «Ischemic crisis» in the flaps after lipoabdominoplasty is present during the first 2 days of the postoperative period. In the future, the progressive recovery of microcirculation in the flaps is noted. The safety of simultaneous abdominoplasty with liposuction has been proven. The advantage of lipoabdominoplasty is better mobilization of flaps which reduces the necessary dissection of the flap, preserves the musculo‑dermal perforants, helps to obtain better body contours and reduce the risk of repeated corrections in the postoperative period.