Vasospasm of the Flap Pedicle

Abstract

The authors concluded that 10% magnesium sulfate applied locally has the best ability to relieve surgically induced vasospasm because of the highest level of significance and reliability. The finding that local application of 2% lidocaine prolongs vasospasm may be surprising.

Vasodilating Effects of Antispasmodic Agents and Their Cytotoxicity in Vascular Smooth Muscle Cells and Endothelial Cells—Potential Application in Microsurgery

“…In vitro studies have also investigated vasodilation [ 17 ]. Although many studies have explored concentration-dependent vasodilatory effects in vitro and in vivo, the physiological effects of drugs on vessels have not been investigated.…”

“…PDE is an enzyme extensively distributed in various systemic organs, including the myocardium, vascular smooth muscle, platelets, liver, bronchi, and lungs. Papaverine inhibits cyclic nucleotide phosphodiesterase, leading to the accumulation of intracellular cyclic guanosine monophosphate and a decrease in the contractile activity of VSMC [ 17 , 18 ]. In addition, they may possess calcium channel antagonistic properties, offering further potential for vasodilation [ 30 ].…”

“…However, there have also been reports of its toxicity. The concentrations of clinically used papaverine are highly acidic (pH, 3–4.5), raising concerns regarding potential tissue toxicity [ 17 ]. Cooper et al [ 35 ] investigated the biochemical and morphological consequences of exposing the internal mammary artery endothelium to papaverine and concluded that the intraluminal injection of papaverine and papaverine solution acidified with physiological saline damaged the internal mammary artery endothelium.…”

Prophylactic Venous Supercharging in Deep Inferior Epigastric Artery Perforator Flap Surgery: A Retrospective Dual-Center Study

“…In this sense, when the lateral tip of the flap comes to be oriented caudally because of ipsilateral flap rotation, it can be de-epithelialized and folded back on itself to augment lower pole fullness and projection (Hartrampf's zone 3). 6 Moreover, the medial portion of the ipsilateral abdominal flap being positioned at the upper pole will be dissected obliquely to recreate smooth breast transition in the chest. In case of contralateral configuration, instead, the lateral tip of the abdominal flap will be located cephalically helping restore the harmonious shape of the new breast ( Fig.…”

The Role of Living Models in the Spending Review Era: How Do You Make the Most of a Rat?

“…Unfortunately, the abovementioned models do not allow the simulation of many factors that normally occur during microsurgical dissection and anastomosis, such as bleeding and vessel spasm 3 4 . Further, they prevent the surgeon from checking the anastomosis using a patency test.…”