Measurement of blood flow and oxygen tension in adjacent tissues in pedicled and free flap head and neck reconstruction

The purpose of this study was to evaluate blood flow and transcutaneous par tial oxygen pressure (TcPO2) in adjacent tissues to free and pedicled flaps following reconstructive procedures used in conjunction with radical surge ry for head and neck cancers. Fifty patients were included. Fourteen patien ts had reconstruction with pedicled flaps and 36 with free flaps. For each patient, TcPO2 and laser Doppler flow measurements were taken at the center of the flap, in adjacent tissue, and in a corresponding contralateral site . Three laser Doppler measurements were performed at each site and a mean v alue recorded. All patients had undergone reconstruction up to 6 months pri or to the time of the measurements. The collected data were analyzed using a Wilcoxon signed rank test. There were no statistically significant differ ences in partial oxygen tension or laser Doppler values between tissues adj acent to free compared to pedicled flaps. Although there is strong evidence to support that free flaps have improved blood flow and partial oxygen ten sion over pedicled flaps, further study is required to evaluate adjacent ti ssues. Flap choice may assist with alteration in blood flow in less favorab le defects such as those in previously irradiated fields and those resultin g from burn scars or chronic infections. (C) 1999 Wiley-Liss, Inc.