Ichinose Akihiro, Tahara Shinya, Terashi Hiroto, Nomura Tadashi, Omori Makoto
Department of Plastic Surgery, Graduate School of Medicine, Kobe University, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan.
Ann Plast Surg. 2003 Feb;50(2):160-4. doi: 10.1097/01.SAP.0000037264.92535.AC.
The risk for free flap thrombosis is greatly influenced by blood flow. Postoperative hemodynamic changes in vascular pedicles of the microvascular skin flap have not been reported, however. This study focuses on the intraoperative and postoperative changes in the flow volume in the vascular pedicles of the free forearm flap examined by color Doppler ultrasonography. The arterial flow volume increased continuously until day 7, compared with which, the volume after flap elevation was 36%. On day 1, it reached only 52%. In the venous pedicle, the flow volume through the cutaneous vein was only 37% compared with that through the radial vena comitans after flap elevation, whereas the volume through both veins was equal on day 7. Drastic changes in the flow explain the possible vascular occlusion during the early postoperative period in the free forearm flap transfer.
游离皮瓣血栓形成的风险受血流的影响很大。然而，目前尚未有关于微血管皮瓣血管蒂术后血流动力学变化的报道。本研究聚焦于通过彩色多普勒超声检查的游离前臂皮瓣血管蒂术中及术后血流量的变化。动脉血流量持续增加直至第7天，与之相比，皮瓣掀起后的血流量为36%。在第1天，仅达到52%。在静脉蒂中，皮瓣掀起后通过皮静脉的血流量仅为通过桡侧伴行静脉血流量的37%，而在第7天，通过两条静脉的血流量相等。血流量的剧烈变化解释了游离前臂皮瓣移植术后早期可能出现的血管闭塞情况。
