Abstract:
BACKGROUND:Perforator flaps are increasingly used in reconstructive surgery. However, the microvascular perfusion pattern within these flaps remains essentially unknown. In perforator flaps, the importance of preserving the skin bridge at the base is still an object of debate. The authors hypothesized that dividing the skin bridge will increase peripheral tissue perfusion in islanded perforator flaps. METHODS:The abdominal panniculus in patients submitted to elective abdominoplasty was used (n = 24). Flap perfusion was measured by dynamic laser-induced fluorescence videoangiography. The fluorescent dye indocyanine green was injected intravenously before and after conversion of a perforator flap with an intact skin bridge into an islanded perforator flap. To evaluate perfusion, mean pixel intensity and mean perfusion index were calculated in a control zone and in two zones in the flap. RESULTS:In zone I (the most peripheral zone), surgical release of the skin bridge increased mean pixel intensity (19.1 ± 1.9 versus 24.1 ± 2.1; p < 0.001). The mean perfusion index was calculated as 7.5 ± 5.5 and 12.6 ± 6.3 before and after surgical conversion to islanded perforator flaps, respectively. In zone II (the more proximal zone), mean pixel intensity increased (from 30.8 ± 2.8 to 33.7 ± 2.3; p < 0.001) after surgical release of the skin bridge. The mean perfusion index was 18.5 ± 11.1 and 15.6 ± 6.2. CONCLUSIONS:In this human experimental study, conversion of a perforator flap with a skin bridge into an islanded perforator flap increases peripheral tissue perfusion. This finding provides a physiologic basis for using islanded perforator flaps, with enhanced flap mobility and length.
journal_name
Plast Reconstr Surgjournal_title
Plastic and reconstructive surgeryauthors
Mešić H,Kirkebøen KA,Bains Rdoi
10.1097/PRS.0b013e31824423f8subject
Has Abstractpub_date
2012-03-01 00:00:00pages
428e-434eissue
3eissn
0032-1052issn
1529-4242pii
00006534-201203000-00008journal_volume
129pub_type
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