Document Detail


A Postoperative Analysis of Perfusion Dynamics in Deep Inferior Epigastric Perforator Flap Breast Reconstruction: A Noninvasive Quantitative Measurement of Flap Oxygen Saturation and Blood Flow.
MedLine Citation:
PMID:  21629069     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND:: The blood supply of microvascular free flaps is rated as very critical, particularly in the first postoperative days. Only a timely recognition of a complication and its treatment can ensure the survival of the flap. To quantify the postoperative perfusion dynamics, we measured the oxygen supply and blood flow of the deep inferior epigastric perforator (DIEP) flaps. METHOD:: A total of 23 patients undergoing DIEP flap breast reconstruction were involved in this study. Noninvasive measurements were performed with the O2C-device, which combines the determination of hemoglobin oxygenation and blood flow using white light and laser light. The first measurement was performed immediately after the flap anastomosis. Further measurements were carried out on the first, third, fifth, and seventh postoperative days. RESULTS:: The preoperative value represents our baseline. With the exception of the third day, all postoperative measurements were above the baseline. On the third postoperative day, there was a decrease in the cutaneous oxygen saturation of 22% and a decrease in blood flow of 18% on average, regardless of the individual fluctuations of patient's blood pressure. CONCLUSIONS:: The postoperative perfusion characteristics of the DIEP flap showed a critical drop in the cutaneous oxygen supply and blood flow on the third postoperative day. This represents a potential risk and should be considered in the postoperative management of the DIEP flap.
Authors:
Afshin Rahmanian-Schwarz; Jens Rothenberger; Amro Amr; Patrick Jaminet; Hans-Eberhard Schaller
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-5-27
Journal Detail:
Title:  Annals of plastic surgery     Volume:  -     ISSN:  1536-3708     ISO Abbreviation:  -     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-6-1     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7805336     Medline TA:  Ann Plast Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
From the Department of Plastic, Reconstructive, Hand, and Burn Surgery, BG-Trauma Center, Eberhard Karls University, Tuebingen, Germany.
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