Monitoring of microcirculation in free transferred musculocutaneous latissimus dorsi flaps by confocal laser scanning microscopy - a promising non-invasive methodical approach

作者：Altintas M A^*; Altintas A A; Guggenheim M; Knobloch K; Niederbichler A D; Vogt P M

来源：Journal of Plastic Reconstructive and Aesthetic Surgery, 2010, 63(1): 111-117.

DOI：10.1016/j.bjps.2008.08.034

• Confocal laser scanning microscopy
• Flap surgery
• Non-invasive monitoring
• Flap surveillance
• Microcirculation
• Histomorphology

Introduction: For the survival of a microvascular tissue transfer, early detection of vascular complications is crucial. In vivo confocal laser scanning microscopy allows real-time, non-invasive evaluation of tissue microcirculation with a high cellular resolution. The aim of this study was to evaluate confocal laser scanning microscopy for early recognition of flap failure.
Methods: Fourteen patients (ages: 40.2 +/- 12.4 years) were monitored postoperatively for a period of 24 h following free microvascular M. latissimus dorsi transfer to the lower extremity using confocal laser scanning microscopy (Vivascope1500; Rochester; New York; USA). The following parameters were evaluated: quantitative blood-cell flow, diameter of capillary loops and minimal thickness of the epidermis.
Results: Venous congestion was characterised by a decrease in blood-cell flow of up to 41%, accompanied by an increase of the diameter of capillary loops of up to 22% and the minimal thickness of the epidermis up to 32%. By contrast, arterial occlusion was clearly verified by a decrease in blood flow of up to 90%, accompanied by an insignificant change of both capillary loop size and epidermal thickness.
Conclusion: Confocal laser scanning microscopy appears to be a useful non-invasive tool for early recognition of flap failure during the monitoring of microsurgical tissue transfer prior to its clinical manifestation.

• 出版日期2010-1