The effect of pedicle artery vasospasm on microhemodynamics in anatomically perfused and extended skin flap tissue

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Publication Details

Author list: Sckell A
Publisher: Lippincott, Williams & Wilkins
Publication year: 2000
Volume number: 45
Issue number: 2
Start page: 155
End page: 161
Number of pages: 7
ISSN: 0148-7043
Languages: English-Great Britain (EN-GB)


Abstract

The aim of this study was to evaluate quantitatively the influence of
pedicle artery vasospasm on the microcirculation in skin flaps,
particularly in the jeopardized extended portions. For this purpose, the
hamster island skin flap model was used, which allowed for simultaneous
assessment of hemodynamics in both the pedicle artery and the
microvasculature of the flap by intravital microscopy. Vasospasm was
induced by applying a V3 microvascular clamp for 30 seconds. Clamping
resulted in a severe vasospasm, with the artery exhibiting a diameter of
7% ± 2% (mean ± standard error) of its original diameter (n = 10; p
< 0.01), and with a reduction of total blood flow to the flap of 11% ±
2% (p < 0.01). Diameter and blood flow recovered gradually to
baseline levels after 25 and 15 minutes respectively. During recovery
from severe pedicle artery vasospasm (moderate to mild vasospasm), the
arterioles in the anatomically perfused flap tissue (n = 38) showed
reactive vasodilation (p < 0.01), which was absent in the extended
tissue (n = 49; p < 0.01 vs. anatomic). At a pedicle artery vasospasm
of 50% of the original diameter, blood flow was restored to normal
levels in the anatomically perfused arterioles, but remained below
baseline in the extended part (partly p < 0.05 vs. baseline and
anatomic). The findings suggest that the development of ischemic
necrosis in extended flap portions may be promoted by prolonged,
moderate vasospasm, which is well tolerated in the anatomically perfused
tissue because of its high capacity for implementing compensatory local
regulatory mechanisms.


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Last updated on 2019-10-08 at 00:15