The Influence of Congestion and Ischemia on Survival of an Experimental Vascular Pedicle Island Flap

Tsuzuki, Kenichi; Yanai, Akira; Tange, Ichiro; Bandoh, Yukihiro

doi:10.1097/00006534-198911000-00012

Cited by 16 publications

(5 citation statements)

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“…9 Using this type of flap, Takayanagi et al 10 reported the influence of vascular insufficiency on the survival of the island flaps. However, Tsuzuki et al 8 claimed that, with the previous types of flaps, it was difficult to accurately measure the surviving area of the flap because of the irregularity of the necrotic area. They introduced a new type of flap that would achieve consistent necrosis in the distal portion.…”

Section: Discussionmentioning

confidence: 99%

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Effect of hyperbaric oxygen on pedicle flaps with compromised circulation

et al. 2002

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The effect of hyperbaric oxygen (HBO) on the survival rate of experimental rat pedicle island flaps with arterial, venous, and combined arteriovenous insufficiency was evaluated. Forty male Wistar rats with pedicle island flaps were divided into four groups with different types of vascular status. Another 40 male Wistar rats, also divided into four groups, were reconstructed in the same manner, but were also exposed to HBO. The results were evaluated using a laser Doppler flowmeter and an estimation of the length of the surviving tissue of the flaps. In evaluations using Kruskal-Wallis test, there was a significant difference in the survival tissue length and mean LD flows among our four untreated groups (P < 0.05). We considered the experimental model defined by Tzusuki and colleagues suitable for our study. Using a Mann-Whitney test, the differences in flap tissue survival length between each type of vascular insufficiency of HBO-treated and untreated groups was significant (P < 0.05). This finding indicates that the survival length was directly improved by the HBO treatment for all type of vascular insufficiency. HBO treatment increased the percentage of survival length and mean LD flows of axial pattern skin flaps with all type of vascular insufficiency. This effect, however, was greatest in the arterial insufficiency flaps.

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Section: Discussionmentioning

confidence: 99%

“…With this point in mind, we used a model designed to ensure constant necrosis in its distal portion in order to investigate the relationship between vascular insufficiency and the HBO therapy. 8…”

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confidence: 99%

Effect of hyperbaric oxygen on pedicle flaps with compromised circulation

et al. 2002

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“…O tempo de isquemia arterial de 16 h utilizado no presente estudo foi maior em relação a outros trabalhos, onde nestes, utilizou-se modelo de isquemia total ou apenas venosa 16,17 . A reperfusão de 45 min.…”

Section: Discussionunclassified

Estudo da isquemia e reperfusão em retalhos cutâneos de ratos

et al. 2002

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INTRODUÇÃO: Múltiplos fatores têm sido implicados na patogênese da lesão de isquemia/reperfusão da pele, incluindo as espécies reativas de oxigênio. OBJETIVO: Estudar a lesão de isquemia/reperfusão em retalhos cutâneos de ratos avaliando os níveis teciduais do malonildialdeído (MDA) e xantina oxidase (XO). MÉTODOS: Foram utilizados 8 ratos Wistar, com peso entre 300 - 400g, sendo confeccionados 2 retalhos epigástricos por animal (controle e experimento), um deles submetido à 16h de isquemia (RI) seguida de 45 min de reperfusão (RR) e o outro controle (RC). Foram colhidas 3 biópsias de pele dos retalhos (RC, RI, RR) e encaminhadas para dosagem de MDA e XO. RESULTADOS: A análise bioquímica mostrou aumento significativo dos níveis teciduais de MDA e XO após a reperfusão em relação aos retalhos controles. CONCLUSÃO: Retalhos epigástricos de ratos submetidos à 16h de isquemia e 45min de reperfusão apresentam elevação dos níveis teciduais de MDA e XO, caracterizando a lipoperoxidação da membrana celular.

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“…2 Physiologically, the low-pressure venous system is more vulnerable to minor insults in extrinsic pressure than the arterial system due to compression from a variety of causes. [3][4][5] Numerous factors affect venous drainage from a flap. First, selection of tissue traversing multiple venosomes may contribute to venous insufficiency in part of a flap, especially in the distal flap furthest from the pedicle vessels.…”

Section: Mechanisms Of Flap Venous Compromisementioning

confidence: 99%

First Aid for Failing Flaps

Talbot

Pribaz

2010

J reconstr Microsurg

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Wound coverage with pedicled (local, regional, or distant) or free flaps is commonplace throughout plastic surgery. However, irrespective of the method of tissue transfer or type of tissue being transferred, inflow and outflow remain key parameters for success. Much has been written detailing complex tissue transfers and delineating arterial and venous anatomy. Despite this, simple venous insufficiency causing venous congestion is common. In experimental models, when arterial inflow is impaired, even mild venous inadequacy affects flap survival. Furthermore, studies have shown that venous congestion is more detrimental to the rate and percentage of flap area surviving than arterial ischemia. Obviously, complete venous occlusion typically requires operative exploration and correction, but many instances occur when venous congestion occurs for reasons other than complete venous thrombosis. Here we detail the basic postoperative "first aid" techniques available to optimize venous drainage. Although these techniques are not a substitute for sound anatomic flap selection, good surgical technique, or re-operation when a significant underlying problem exists, they do offer additional options to improve flap outcomes.

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The Influence of Congestion and Ischemia on Survival of an Experimental Vascular Pedicle Island Flap

Cited by 16 publications

References 0 publications

Effect of hyperbaric oxygen on pedicle flaps with compromised circulation

Effect of hyperbaric oxygen on pedicle flaps with compromised circulation

Estudo da isquemia e reperfusão em retalhos cutâneos de ratos

First Aid for Failing Flaps

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