Intraoperative Blood Flow Analysis of Free Flaps with Arteriovenous Loops for Autologous Microsurgical Reconstruction.

ICG fluoroscopy interdisciplinary plastic surgery microsurgery plastic surgery reconstructive surgery surgical innovation

Journal

Journal of clinical medicine
ISSN: 2077-0383
Titre abrégé: J Clin Med
Pays: Switzerland
ID NLM: 101606588

Informations de publication

Date de publication:
02 Dec 2023
Historique:
received: 24 10 2023
revised: 28 11 2023
accepted: 29 11 2023
medline: 9 12 2023
pubmed: 9 12 2023
entrez: 9 12 2023
Statut: epublish

Résumé

Arteriovenous (AV) loops help to overcome absent or poor-quality recipient vessels in highly complex microvascular free flap reconstruction cases. There are no studies on blood flow and perfusion patterns. The purpose of this study was to evaluate and compare intraoperative hemodynamic characteristics of AV loops followed by free tissue transfer for thoracic wall and lower extremity reconstruction. this prospective clinical study combined Transit-Time Flowmetry and microvascular Indocyanine Green Angiography for the assessment of blood flow volume, arterial vascular resistance and intrinsic transit time at the time of AV loop construction and on the day of free flap transfer. A total of 11 patients underwent AV loop creation, of whom five required chest wall reconstruction and six required reconstruction of the lower extremities. In seven of these cases, the latissimus dorsi flap and in four cases the vertical rectus abdominis myocutaneous (VRAM) flap was used as a free flap. At the time of loop construction, the blood flow volume of AV loops was 466 ± 180 mL/min, which increased to 698 ± 464 mL/min on the day of free tissue transfer ( This is the first study to perform intraoperative blood flow and hemodynamic measurements of AV loops followed by free tissue transfer. Our results show hemodynamic differences and contribute to deeper understanding of the properties of AV loops for free flap reconstruction.

Sections du résumé

BACKGROUND BACKGROUND
Arteriovenous (AV) loops help to overcome absent or poor-quality recipient vessels in highly complex microvascular free flap reconstruction cases. There are no studies on blood flow and perfusion patterns. The purpose of this study was to evaluate and compare intraoperative hemodynamic characteristics of AV loops followed by free tissue transfer for thoracic wall and lower extremity reconstruction.
METHODS METHODS
this prospective clinical study combined Transit-Time Flowmetry and microvascular Indocyanine Green Angiography for the assessment of blood flow volume, arterial vascular resistance and intrinsic transit time at the time of AV loop construction and on the day of free flap transfer.
RESULTS RESULTS
A total of 11 patients underwent AV loop creation, of whom five required chest wall reconstruction and six required reconstruction of the lower extremities. In seven of these cases, the latissimus dorsi flap and in four cases the vertical rectus abdominis myocutaneous (VRAM) flap was used as a free flap. At the time of loop construction, the blood flow volume of AV loops was 466 ± 180 mL/min, which increased to 698 ± 464 mL/min on the day of free tissue transfer (
CONCLUSION CONCLUSIONS
This is the first study to perform intraoperative blood flow and hemodynamic measurements of AV loops followed by free tissue transfer. Our results show hemodynamic differences and contribute to deeper understanding of the properties of AV loops for free flap reconstruction.

Identifiants

pubmed: 38068529
pii: jcm12237477
doi: 10.3390/jcm12237477
pmc: PMC10707281
pii:
doi:

Types de publication

Journal Article

Langues

eng

Références

Ann Plast Surg. 2001 Aug;47(2):148-52
pubmed: 11506322
Br J Oral Maxillofac Surg. 2017 Jul;55(6):628-630
pubmed: 28404211
Postepy Dermatol Alergol. 2023 Apr;40(2):253-258
pubmed: 37312925
Microsurgery. 2018 Sep;38(6):706-717
pubmed: 28738446
Plast Reconstr Surg. 1998 Apr;101(5):1262-7
pubmed: 9529211
Plast Reconstr Surg Glob Open. 2021 Nov 22;9(11):e3881
pubmed: 34815918
Medicina (Kaunas). 2020 Nov 23;56(11):
pubmed: 33238390
Eur Arch Otorhinolaryngol. 2023 Feb;280(2):811-817
pubmed: 36056974
Front Surg. 2019 Jul 02;6:39
pubmed: 31334246
J Stomatol Oral Maxillofac Surg. 2022 Nov;123(6):e894-e898
pubmed: 34971838
Microsurgery. 2009;29(7):509-14
pubmed: 19306390
Plast Reconstr Surg Glob Open. 2018 Nov 28;6(11):e1913
pubmed: 30881776
Int Wound J. 2020 Oct;17(5):1496-1507
pubmed: 32573103
World J Surg Oncol. 2019 Sep 2;17(1):154
pubmed: 31477142
Sci Rep. 2020 Jan 22;10(1):939
pubmed: 31969630
J Craniomaxillofac Surg. 2016 Nov;44(11):1833-1841
pubmed: 27745767
Plast Reconstr Surg. 2016 Sep;138(3):510e-518e
pubmed: 27556627
Aust N Z J Surg. 1982 Apr;52(2):182-4
pubmed: 6952863
Eur Surg. 2016;48(6):326-333
pubmed: 29142584
Methods Med Res. 1958;7:98-9
pubmed: 13516482
J Reconstr Microsurg. 2012 May;28(4):273-8
pubmed: 22492006
J Reconstr Microsurg. 1992 May;8(3):195-200
pubmed: 1629799
J Pers Med. 2022 Mar 16;12(3):
pubmed: 35330481
Ann Thorac Surg. 2000 Jul;70(1):212-7
pubmed: 10921710
Microsurgery. 2010;30(2):91-6
pubmed: 19790185
Plast Reconstr Surg. 2000 Jun;105(7):2395-9
pubmed: 10845292
J Reconstr Microsurg. 2000 Feb;16(2):101-6
pubmed: 10706199
J Plast Reconstr Aesthet Surg. 2021 Mar;74(3):512-522
pubmed: 33039304
Handchir Mikrochir Plast Chir. 2012 Apr;44(2):84-8
pubmed: 22495959
J Am Col Certif Wound Spec. 2009 May 01;1(1):6-11
pubmed: 24527102
Int Wound J. 2020 Feb;17(1):107-116
pubmed: 31668019
Ann Plast Surg. 2001 Jun;46(6):590-3
pubmed: 11405356
Microsurgery. 2004;24(2):104-13
pubmed: 15038014
J Plast Reconstr Aesthet Surg. 2020 Sep;73(9):1775-1784
pubmed: 32522517
Plast Reconstr Surg. 2020 Jul;146(1):1e-10e
pubmed: 32590635
J Reconstr Microsurg. 2009 Jan;25(1):39-45
pubmed: 18942044
J Clin Med. 2023 Mar 08;12(6):
pubmed: 36983115
J Plast Reconstr Aesthet Surg. 2018 Mar;71(3):394-401
pubmed: 28993127
J Craniomaxillofac Surg. 2015 Jun;43(5):643-8
pubmed: 25913628
J Reconstr Microsurg. 2001 Apr;17(3):163-7
pubmed: 11336147
J Reconstr Microsurg. 1997 Feb;13(2):125-30
pubmed: 9044187
World J Plast Surg. 2018 Sep;7(3):377-381
pubmed: 30560081

Auteurs

Alexander Geierlehner (A)

Department of Plastic and Hand Surgery and Laboratory for Tissue Engineering and Regenerative Medicine, University Hospital Erlangen, Friedrich Alexander University Erlangen-Nürnberg FAU, 91054 Erlangen, Germany.

Raymund E Horch (RE)

Department of Plastic and Hand Surgery and Laboratory for Tissue Engineering and Regenerative Medicine, University Hospital Erlangen, Friedrich Alexander University Erlangen-Nürnberg FAU, 91054 Erlangen, Germany.

Ingo Ludolph (I)

Department of Plastic and Hand Surgery and Laboratory for Tissue Engineering and Regenerative Medicine, University Hospital Erlangen, Friedrich Alexander University Erlangen-Nürnberg FAU, 91054 Erlangen, Germany.

Werner Lang (W)

Department of Vascular Surgery, University Hospital Erlangen, Friedrich Alexander University Erlangen-Nürnberg FAU, 91054 Erlangen, Germany.

Ulrich Rother (U)

Department of Vascular Surgery, University Hospital Erlangen, Friedrich Alexander University Erlangen-Nürnberg FAU, 91054 Erlangen, Germany.

Alexander Meyer (A)

Department of Vascular Surgery, University Hospital Erlangen, Friedrich Alexander University Erlangen-Nürnberg FAU, 91054 Erlangen, Germany.
Department of Vascular Surgery and Phlebology, Helios Klinikum Berlin-Buch, 13125 Berlin, Germany.

Andreas Arkudas (A)

Department of Plastic and Hand Surgery and Laboratory for Tissue Engineering and Regenerative Medicine, University Hospital Erlangen, Friedrich Alexander University Erlangen-Nürnberg FAU, 91054 Erlangen, Germany.

Classifications MeSH