Casanova R, Iribarren O, Grotting J C, Vasconez L O
Division of Plastic Surgery, University of Alabama, Birmingham 35294.
Ann Plast Surg. 1988 Feb;20(2):112-6. doi: 10.1097/00000637-198802000-00003.
A dermal surface fluorometer was used to monitor vascular perfusion in 22 patients who underwent reconstructive surgical procedures with a variety of flaps (e.g., skin flaps, musculocutaneous flaps, fasciocutaneous flaps, and Z-plasties). Sodium fluorescein (1.5 mg per kilogram of body weight) was administered intravenously at the completion of the operative procedure. Quantitative fluorescence readings were obtained at different points in each flap by means of the surface fluorometer (Fluoroscan). The readings were taken at several time intervals and compared with those of normal skin (control). A perfusion ratio was determined in each case according to the following formula: flap reading/(normal skin control reading X 100). Partial necrosis occurred in 4 patients, correlating with low fluorescein perfusion measurements. From our findings, it appears that a perfusion ratio of 15% or greater 10 minutes following injection will accurately predict tissue viability. No systemic reactions were observed in these patients. We believe that this minimally invasive technique should be of considerable assistance in the postoperative evaluation of flap viability.
使用皮肤表面荧光计对22例行各种皮瓣（如皮瓣、肌皮瓣、筋膜皮瓣和Z成形术）重建手术的患者进行血管灌注监测。手术结束时静脉注射荧光素钠（每千克体重1.5毫克）。通过表面荧光计（Fluoroscan）在每个皮瓣的不同点获取定量荧光读数。在几个时间间隔进行读数，并与正常皮肤（对照）的读数进行比较。根据以下公式确定每种情况下的灌注率：皮瓣读数/（正常皮肤对照读数×100）。4例患者发生部分坏死，与荧光素灌注测量值低相关。根据我们的研究结果，注射后10分钟灌注率达到15%或更高似乎可以准确预测组织活力。这些患者未观察到全身反应。我们认为，这种微创技术在皮瓣活力的术后评估中应会有很大帮助。
