MICROCIRCULATORY CONSEQUENCES OF MICROVASCULAR SURGERY

Although free tissue transfer success has been greatly improved by dev elopments in operating microscopes, microsutures, microinstruments, an d technique, free flap and replant failure remain a significant proble m under certain adverse circumstances. The nature of these failures is often multifactorial and remains poorly understood. A greater underst anding of the processes involved would provide the potential for great er pharmacological control of any adverse conditions prevailing and wo uld thus offer the prospect of more effective adjunctive therapy in th e presence of such adverse conditions. Research endeavors in this area have been hindered by the absence of good research models. The isolat ed rat cremaster muscle model is a recently developed model that simul ates the conditions of free tissue transfer. Using this model, both th rombus formation and numerous microcirculatory parameters can be measu red. The microcirculatory parameters studied to date include the forma tion of thromboembolism, capillary perfusion, vessel diameters, red bl ood cell velocity, leukocyte-endothelium interaction, and microvascula r leakage. The isolated rat cremaster muscle model addresses many of t he shortcomings of earlier research models and offers the promise of a nswering at least some of the many unanswered questions relating to fr ee flap and replant failure.