Abstract:
:The most common complication in flap surgery is of a circulatory nature. Impeded blood flow leads to altered metabolism in the tissue. Possible metabolic differences between different zones of the transverse rectus abdominis muscle (TRAM) flap were studied and the metabolism of pedicled and free TRAM flaps was compared intraoperatively and postoperatively. The method used was microdialysis, which is a useful technique for following local metabolic changes continuously in various tissues.Twenty-two patients with a pedicled or free TRAM flap were monitored using the microdialysis technique. Two microdialysis catheters were placed subcutaneously in the flap (zone I and zone II), and a third one was placed subcutaneously in the flank to serve as a control. The flaps were monitored intraoperatively and postoperatively for 3 days with repeated analyses of extracellular glucose, lactate, and glycerol concentrations. An additional analysis of pyruvate was performed in some patients to calculate the lactate-to-pyruvate ratio. This study showed that glucose, lactate, and glycerol change in a characteristic way when complete ischemia (i.e., complete inhibition of the blood circulation) is present. A slower stabilization with prolonged metabolic signs of ischemia, such as lower glucose and higher lactate and glycerol concentrations, was seen in zone II compared with zone I, and more pronounced metabolic signs of ischemia, but with a faster recovery, were detected in the free TRAM flap group than in the pedicled TRAM flap group. The fact that the metabolites returned to normal earlier in free flaps than in pedicled flaps may indicate that free TRAM flaps sustain less ischemic damage because of better and more vigorous perfusion.
journal_name
Plast Reconstr Surgjournal_title
Plastic and reconstructive surgeryauthors
Edsander-Nord A,Röjdmark J,Wickman Mdoi
10.1097/00006534-200202000-00037subject
Has Abstractpub_date
2002-02-01 00:00:00pages
664-73issue
2eissn
0032-1052issn
1529-4242journal_volume
109pub_type
杂志文章abstract:BACKGROUND:Evidence-based medicine, particularly randomized controlled trials, influences many daily decisions within the medical specialties. The structure of questions asked during the history and selection of physical examination maneuvers, diagnostic tests, and treatment regimens are all guided by evidence-based me...
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abstract::As we have gained experience with the extended superficial musculoaponeurotic system (SMAS) technique in face lifting, refinements in our procedure have led to increased consistency in results. The important factors that have led to our technical modifications include the following: (1) the significance of the retaini...
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journal_title:Plastic and reconstructive surgery
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doi:10.1097/00006534-199112000-00006
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journal_title:Plastic and reconstructive surgery
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更新日期:1998-06-01 00:00:00
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doi:
更新日期:1994-03-01 00:00:00
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更新日期:2007-08-01 00:00:00
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更新日期:2017-09-01 00:00:00
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
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更新日期:2000-09-01 00:00:00
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