The delay phenomenon and its application in the rectus abdominis myocutaneous flap. Part two: Haemodynamic evaluation

TitleThe delay phenomenon and its application in the rectus abdominis myocutaneous flap. Part two: Haemodynamic evaluation
Publication TypeJournal Article
Year of Publication1996
AuthorsRibuffo, D, De Cicco E, Tinti A, Malato M, Fanini L, Scuderi N
JournalSul fenomeno dell'autonomizzazione e sulla sua applicazione nel lembo miocutaneo di retto dell'addome. Parte II: Studio emodinamicoRivista Italiana di Chirurgia Plastica
Volume28
Issue3
Pages295 - 301
Abstract

In the first part of our study about the delay phenomenon and of its applications in breast reconstruction with the TRAM flap we have seen that this procedure is associated with a marked decrease in the number of complications. Although clinical results must be considered preliminary, because of the small number of patients treated, it nevertheless confirms the encouraging results by the haemodynamic studies conducted at the same time. To provide objective assessment and to measure the changes caused by delay to the TRAM flap haemodynamics, we have investigated 28 consecutive patients: 18 patients who had undergone delayed TRAM reconstruction and 10 patients (control group) who had undergone traditional TRAM reconstruction. We have used Laser Doppler Flowmetry to study the flap's cutaneous perfusion in 10 out of 18 patients who had undergone breast reconstruction after TRAM selective delay (see part 1 of this study) and in 10 of the 15 patients who had undergone traditional TRAM reconstruction. Cutaneous flowmetry has been measured according to a standard protocol, based of Tuominen's original protocol, before, during and after reconstruction. In ten of the 18 patients who had undergone TRAM delay, we conducted colour flow duplex scanning to assess diameter changes and resistivity of the superior epigagtric artery prior to and after delay. Thig was done on a weekly basis up to a month after delay, with a straight 7.5 MhZ and/or 10 Mhz sound placed after the origin of the intercostal artery. Of the latter ten patients, five have undergone breast reconstruction, two are included in the group studied with Laser Doppler Flowmetry (and have completed breast reconstruction) and three only have not completed reconstruction procedures.

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