The intrinsic transit time of free microvascular flaps: Clinical and prognostic implications

Abstract

This study demonstrates a significant predictive value of the intrinsic flap transit time for the development of flap compromise and early re-exploration surgery.

A Review of Thrombosis and Antithrombotic Therapy in Microvascular Surgery

“…In recent years, new approaches have been introduced. These include near-infrared indocyanine green video angiography, which provides real-time information on arterial and venous patency [24], and thromboelastography, a test capable of detecting hypercoagulable states that can be used for predicting postoperative thromboembolic complications. These methods are still being tested in the clinical setting.…”

Assessment of free microvascular flap perfusion by intraoperative fluorescence angiography in craniomaxillofacial surgery

“…3. Quantification of the arterial and venous blood flow revealing a significant increase in the blood flow index (BFI) on the arterial as well as venous side in the neck area compared to the periphery (flap origin) a: Furthermore, maximum intensity (MaxInt) turned out to be significantly elevated compared to perfusion at the original site of the flaps in the supplying pedicle vessels b: Half-time to MaxInt (t 1/2 ), on the other hand, significantly decreased in the arterial as well as venous vessels c. time in free flaps, presumably an essential predictor for postoperative flap survival as published by Holm et al (2010). Future experiments should distinguish between the number of draining veins on the one hand, and the applied type of venous anastomoses, end-to-end and/or end-to-side, on the other, which was not possible due to the low number of patients in our analysis.…”

“…Intraoperative fluorescence angiography, initially descripted by Feindel et al, provides a tool to assess blood flow within arteries and veins of submillimeter diameter (Feindel et al, 1967;Holm et al, 2010). Besides offering real-time dynamic visualization enabling visual evaluation of microvascular anastomoses or bypass grafts, fluorescence angiography in connection with Flow800 (Carl Zeiss AG, Oberkochen, Germany) provides a tool to quantitatively measure blood flow after indocyanin green (ICG) application (Mucke et al, 2010).…”

Intraoperative free jejunum flap monitoring with indocyanine green near-infrared angiography

“…Fully perfused dye gradually diminished from the jejunum graft ( Fig with the clinical outcome [5]. Since then, the availability of ICGA for intraoperative free flap monitoring has been demonstrated [6,7]. However, the application of this technique for a free jejunum graft has not been reported to date.…”

“…Intraoperative blood flow dose not necessarily reflect the flap success after the wound closure. However, the intrinsic transit time of free microvascluar flaps has a significant predictive value for the development of flap compromise and early re-exploration surgery [7].…”