Vascular Occlusion in a Porcine Flap Model: Effects on Blood Cell Concentration and Oxygenation
Background:. Venous congestion in skin flaps is difficult to detect. This study evaluated the ability of tissue viability imaging (TiVi) to measure changes in the concentration of red blood cells (CRBC), oxygenation, and heterogeneity during vascular provocations in a porcine fasciocutaneous flap mo...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer
2017-11-01
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| Series: | Plastic and Reconstructive Surgery, Global Open |
| Online Access: | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000001531 |
| _version_ | 1830429968368140288 |
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| author | Max Bergkvist, MD Johan Zötterman, MD Joakim Henricson, PhD Fredrik Iredahl, MD, PhD Erik Tesselaar, PhD Simon Farnebo, MD, PhD |
| author_facet | Max Bergkvist, MD Johan Zötterman, MD Joakim Henricson, PhD Fredrik Iredahl, MD, PhD Erik Tesselaar, PhD Simon Farnebo, MD, PhD |
| author_sort | Max Bergkvist, MD |
| collection | DOAJ |
| description | Background:. Venous congestion in skin flaps is difficult to detect. This study evaluated the ability of tissue viability imaging (TiVi) to measure changes in the concentration of red blood cells (CRBC), oxygenation, and heterogeneity during vascular provocations in a porcine fasciocutaneous flap model.
Methods:. In 5 pigs, cranial gluteal artery perforator flaps were raised (8 flaps in 5 pigs). The arterial and venous blood flow was monitored with ultrasonic flow probes. CRBC, tissue oxygenation, and heterogeneity in the skin were monitored with TiVi during baseline, 50% and 100% venous occlusion, recovery, 100% arterial occlusion and final recovery, thereby simulating venous and arterial occlusion of a free fasciocutaneous flap. A laser Doppler probe was used as a reference for microvascular perfusion in the flap.
Results:. During partial and complete venous occlusion, increases in CRBC were seen in different regions of the flap. They were more pronounced in the distal part. During complete arterial occlusion, CRBC decreased in all but the most distal parts of the flap. There were also increases in tissue oxygenation and heterogeneity during venous occlusion.
Conclusions:. TiVi measures regional changes in CRBC in the skin of the flap during arterial and venous occlusion, as well as an increase in oxygenated hemoglobin during venous occlusion that may be the result of reduced metabolism and impaired delivery of oxygen to the tissue. TiVi may provide a promising method for measuring flap viability because it is hand-held, easy to-use, and provides spatial information on venous congestion. |
| first_indexed | 2024-12-21T01:42:45Z |
| format | Article |
| id | doaj.art-e260a359fd064c64804ebbf5bf880b2c |
| institution | Directory Open Access Journal |
| issn | 2169-7574 |
| language | English |
| last_indexed | 2024-12-21T01:42:45Z |
| publishDate | 2017-11-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Plastic and Reconstructive Surgery, Global Open |
| spelling | doaj.art-e260a359fd064c64804ebbf5bf880b2c2022-12-21T19:20:07ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742017-11-01511e153110.1097/GOX.0000000000001531201711000-00015Vascular Occlusion in a Porcine Flap Model: Effects on Blood Cell Concentration and OxygenationMax Bergkvist, MD0Johan Zötterman, MD1Joakim Henricson, PhD2Fredrik Iredahl, MD, PhD3Erik Tesselaar, PhD4Simon Farnebo, MD, PhD5From the *Department of Plastic Surgery, Hand Surgery and Burns, Linköping University, Linköping, Sweden; †Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden; and ‡Department of Radiation Physics, Linköping University, Linköping, Sweden.From the *Department of Plastic Surgery, Hand Surgery and Burns, Linköping University, Linköping, Sweden; †Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden; and ‡Department of Radiation Physics, Linköping University, Linköping, Sweden.From the *Department of Plastic Surgery, Hand Surgery and Burns, Linköping University, Linköping, Sweden; †Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden; and ‡Department of Radiation Physics, Linköping University, Linköping, Sweden.From the *Department of Plastic Surgery, Hand Surgery and Burns, Linköping University, Linköping, Sweden; †Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden; and ‡Department of Radiation Physics, Linköping University, Linköping, Sweden.From the *Department of Plastic Surgery, Hand Surgery and Burns, Linköping University, Linköping, Sweden; †Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden; and ‡Department of Radiation Physics, Linköping University, Linköping, Sweden.From the *Department of Plastic Surgery, Hand Surgery and Burns, Linköping University, Linköping, Sweden; †Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden; and ‡Department of Radiation Physics, Linköping University, Linköping, Sweden.Background:. Venous congestion in skin flaps is difficult to detect. This study evaluated the ability of tissue viability imaging (TiVi) to measure changes in the concentration of red blood cells (CRBC), oxygenation, and heterogeneity during vascular provocations in a porcine fasciocutaneous flap model. Methods:. In 5 pigs, cranial gluteal artery perforator flaps were raised (8 flaps in 5 pigs). The arterial and venous blood flow was monitored with ultrasonic flow probes. CRBC, tissue oxygenation, and heterogeneity in the skin were monitored with TiVi during baseline, 50% and 100% venous occlusion, recovery, 100% arterial occlusion and final recovery, thereby simulating venous and arterial occlusion of a free fasciocutaneous flap. A laser Doppler probe was used as a reference for microvascular perfusion in the flap. Results:. During partial and complete venous occlusion, increases in CRBC were seen in different regions of the flap. They were more pronounced in the distal part. During complete arterial occlusion, CRBC decreased in all but the most distal parts of the flap. There were also increases in tissue oxygenation and heterogeneity during venous occlusion. Conclusions:. TiVi measures regional changes in CRBC in the skin of the flap during arterial and venous occlusion, as well as an increase in oxygenated hemoglobin during venous occlusion that may be the result of reduced metabolism and impaired delivery of oxygen to the tissue. TiVi may provide a promising method for measuring flap viability because it is hand-held, easy to-use, and provides spatial information on venous congestion.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000001531 |
| spellingShingle | Max Bergkvist, MD Johan Zötterman, MD Joakim Henricson, PhD Fredrik Iredahl, MD, PhD Erik Tesselaar, PhD Simon Farnebo, MD, PhD Vascular Occlusion in a Porcine Flap Model: Effects on Blood Cell Concentration and Oxygenation Plastic and Reconstructive Surgery, Global Open |
| title | Vascular Occlusion in a Porcine Flap Model: Effects on Blood Cell Concentration and Oxygenation |
| title_full | Vascular Occlusion in a Porcine Flap Model: Effects on Blood Cell Concentration and Oxygenation |
| title_fullStr | Vascular Occlusion in a Porcine Flap Model: Effects on Blood Cell Concentration and Oxygenation |
| title_full_unstemmed | Vascular Occlusion in a Porcine Flap Model: Effects on Blood Cell Concentration and Oxygenation |
| title_short | Vascular Occlusion in a Porcine Flap Model: Effects on Blood Cell Concentration and Oxygenation |
| title_sort | vascular occlusion in a porcine flap model effects on blood cell concentration and oxygenation |
| url | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000001531 |
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