Document Detail


Monitoring of microcirculation in free transferred musculocutaneous latissimus dorsi flaps by confocal laser scanning microscopy--a promising non-invasive methodical approach.
MedLine Citation:
PMID:  19027386     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: For the survival of a microvascular tissue transfer, early detection of vascular complications is crucial. In vivo confocal laser scanning microscopy allows real-time, non-invasive evaluation of tissue microcirculation with a high cellular resolution. The aim of this study was to evaluate confocal laser scanning microscopy for early recognition of flap failure. METHODS: Fourteen patients (ages: 40.2+/-12.4 years) were monitored postoperatively for a period of 24h following free microvascular M. latissimus dorsi transfer to the lower extremity using confocal laser scanning microscopy (Vivascope1500; Rochester; New York; USA). The following parameters were evaluated: quantitative blood-cell flow, diameter of capillary loops and minimal thickness of the epidermis. RESULTS: Venous congestion was characterised by a decrease in blood-cell flow of up to 41%, accompanied by an increase of the diameter of capillary loops of up to 22% and the minimal thickness of the epidermis up to 32%. By contrast, arterial occlusion was clearly verified by a decrease in blood flow of up to 90%, accompanied by an insignificant change of both capillary loop size and epidermal thickness. CONCLUSION: Confocal laser scanning microscopy appears to be a useful non-invasive tool for early recognition of flap failure during the monitoring of microsurgical tissue transfer prior to its clinical manifestation.
Authors:
M A Altintas; A A Altintas; M Guggenheim; K Knobloch; A D Niederbichler; P M Vogt
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Publication Detail:
Type:  Journal Article     Date:  2008-11-22
Journal Detail:
Title:  Journal of plastic, reconstructive & aesthetic surgery : JPRAS     Volume:  63     ISSN:  1878-0539     ISO Abbreviation:  J Plast Reconstr Aesthet Surg     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2010-02-04     Completed Date:  2010-04-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101264239     Medline TA:  J Plast Reconstr Aesthet Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  111-7     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2008 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.
Affiliation:
Department of Plastic, Hand and Reconstructive Surgery, Medical School Hannover, 30625 Hannover, Germany. altintas.mehmet@mh-hannover.de
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MeSH Terms
Descriptor/Qualifier:
Adult
Female
Graft Survival*
Humans
Male
Microcirculation*
Microscopy, Confocal*
Monitoring, Physiologic / methods*
Statistics, Nonparametric
Surgical Flaps / blood supply*
Comments/Corrections
Comment In:
J Plast Reconstr Aesthet Surg. 2010 Jan;63(1):118-9   [PMID:  19185558 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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