VENOUS FLAP ISCHEMIA - MICROCIRCULATORY CHANGES IN EXPERIMENTAL FLAPSIN A RABBIT MODEL

Citation
A. Gurlek et al., VENOUS FLAP ISCHEMIA - MICROCIRCULATORY CHANGES IN EXPERIMENTAL FLAPSIN A RABBIT MODEL, Journal of reconstructive microsurgery, 14(2), 1998, pp. 121-126
Citations number
16
Categorie Soggetti
Surgery
ISSN journal
0743684X
Volume
14
Issue
2
Year of publication
1998
Pages
121 - 126
Database
ISI
SICI code
0743-684X(1998)14:2<121:VFI-MC>2.0.ZU;2-T
Abstract
This study was designed to investigate the simultaneous changes in blo od flow and microcirculation in an island flap during venous occlusion (venous ischemia), in an ischemia/reperfusion injury model in the rab bit. An island groin flap based on the inferior epigastric vessels was harvested in 15 rabbits. The flap was rendered ischemic for 3 hr (n=5 ) or 4 hr (n=10, 5 heparinized and 5 not), by applying a microvascular clamp to the inferior epigastric vein. Transonic Doppler and laser Do ppler were used to monitor blood flow in the epigastric artery and mic rocirculation of the flap for 1 hr after flap elevation, 1 hr after oc clusion, and for 3 hr at the end of the ischemic period. Venous occlus ion was followed by a rapid decrease of blood flow and microcirculatio n readings. After ischemia, both blood flow and microcirculation readi ngs in the flap were significantly decreased, compared to pre-ischemic values in all groups. In the 3-hr ischemia group, blood flow readings returned to pre-stress values, while microcirculation remained signif icantly lower. In the 4-hr ischemia group treated with heparin, blood flow in the artery settled at levels significantly lower than pre-stre ss readings; however, microcirculation of the flap was ultimately full y restored to pre-ischemic values. in the 4-hr ischemia group, both bl ood flow and microcirculation in the flap settled at levels significan tly lower than pre-stress values. The authors concluded that tolerance for venous ischemia is time-dependent in this model and that venous i schemia is more deleterious than global ischemia. Administration of he parin may alter the time frame of ischemia/reperfusion injury and may prevent the harmful effects of injury at the microcirculatory level.