The inflammatory response in three different flap procedures was inves
tigated by measuring the preoperative and postoperative levels of C-re
active protein, leukocyte count, and body temperature. Patients schedu
led for delayed breast reconstruction were operated on with the latera
l thoracodorsal flap, the latissimus dorsi flap, or the pedicled TRAM
flap. All patients received 2 gm of intravenous cloxacillin for antibi
otic prophylaxis and 1 gm of paracetamol four times a day as basic tre
atment for postoperative pain. Within each treatment group, significan
t postoperative changes in C-reactive protein levels, leukocyte count,
and body temperature were noted when compared with preoperative value
s. The highest C-reactive protein level (130 mg/ml) was found in the T
RAM group on the third postoperative day. The kinetic pattern of C-rea
ctive protein was similar for the latissimus dorsi flap and lateral th
oracodorsal flap procedures, but the maximum C-reactive protein levels
were significantly lower, 74 and 44 mg/ml respectively. Small (0.5 to
0.9 degrees C) but significant differences in body temperature were a
lso noted on the second and third postoperative day. The TRAM flap gro
up had the highest, the latissimus dorsi flap group intermediate, and
the lateral thoracodorsal flap group the lowest value. The postoperati
ve C-reactive protein levels seem to reflect the extent of the surgica
l trauma.