PDF herunterladen
J Reconstr Microsurg 2002; 18(7): 599-608
DOI: 10.1055/s-2002-35099
Copyright © 2002 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Effect of Blood Loss on Vascular Responsiveness in Pedicled Groin Flaps in a Rat Model

Ilpo Kinnunen1 , Esa Laurikainen1 , Aleksi Schrey1 , Pekka Laippala2 , Kalle Aitasalo1
  • 1Department of Otorhinolaryngology, Turku University Central Hospital, Turku, Finland
  • 2Department of Public Health/Biometry Unit, University of Tampere, Research Unit, Tampere University Hospital, Tampere, Finland
Weitere Informationen

Publikationsverlauf

Publikationsdatum:
29. Oktober 2002 (online)

Auch verfügbar auf
    Lizenzen und Reprints

ABSTRACT

Using the clamping method (closing and opening the flap feeding artery) and continuous laser Doppler flowmetry, the effects of blood withdrawals on flap blood flow and on active and passive mechanisms regulating it were investigated in 12 Sprague-Dawley rats. Measurements were made during stable normovolemic conditions, during hypovolemia (after 3 ml/kg and after 6 ml/kg blood withdrawal), and after retransfusion of the shed blood. The continuous blood flow responses during and after the clamping procedure were analyzed. After clamp release, the increase in blood flow, duration of overshoot, and peak flow of overshoot were significantly greater (the level of significance was set equal to 0.05) in the registrations performed after blood withdrawals than before them. The post-ischemic response curves indicating significantly increased flap hyperemia during reperfusion in the registrations after blood withdrawals may be associated with decreased vascular resistance in the flap. Thus, the authors conclude that a short-term decrease in blood pressure caused by blood loss may prepare the flap microcirculation for tolerating more ischemia.

KEYWORDS

Hemodynamics - blood loss - blood pressure - blood flow - laser doppler flowmetry - free flap - microsurgery - vascular responsiveness

REFERENCES

  • 1 Al Qattan M M, Boyd B. Complications in head and neck microsurgery.  Microsurgery . 1993;  14 187-195
    PubMedGoogle Scholar
  • 2 Khouri R K, Cooley B C, Kunselman A R. A prospective study of microvascular free-flap surgery and outcome.  Plast Reconstr Surg . 1998;  102 711-721
    Google Scholar
  • 3 Sigurdsson G H, Banic A, Wheatley A M. Effects of halothane and isoflurane anaesthesia on microcirculatory blood flow in musculocutaneous flaps.  Br J Anaesth . 1994;  73 826-832
    CrossrefPubMedGoogle Scholar
  • 4 Bond R F, Lackey G F, Taxis J A. Factors governing cutaneous vasoconstriction during hemorrhage.  Am J Phys . 1970;  219 1210
    PubMedGoogle Scholar
  • 5 Guyton A C, Hall J E. Textbook of Medical Physiology, 10th Ed. Philadelphia: W.B. Saunders Company 2000
    Google Scholar
  • 6 Wang W Z, Anderson G, Maldonado C. Attenuation of vasospasm and capillary no-reflow by ischemic preconditioning in skeletal muscle.  Microsurgery . 1996;  17 324-329
    CrossrefPubMedGoogle Scholar
  • 7 Standen N B, Quayle J M, Davies N W. Hyperpolarizing vasodilators activate ATP sensitive K+ channels in arterial smooth muscle.  Science . 1989;  145 177-180
    PubMedGoogle Scholar
  • 8 Ren T, Avinash G B, Nuttall A L. Dynamic response of cochlear blood flow to occlusion of anterior inferior cerebellar artery in guinea pigs.  J Appl Physiol . 1994;  76 212-217
    PubMedGoogle Scholar
  • 9 Kinnunen I, Laurikainen E, Schrey A. Changes in blood flow in the epigastric free flap after microsurgical artery anastomoses in rats.  Acta Otolaryngol Suppl . 2000;  543 254-256
    PubMedGoogle Scholar
  • 10 Kinnunen I, Laurikainen E, Schrey A. Changes in blood flow in the partially elevated epigastric pedicled flap in response to occlusion of the femoral artery in rats.  J Reconstr Microsurg . 2001;  17 371-377
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 11 Kinnunen I, Laurikainen E, Schrey A. Effect of acute ischemic preconditioning on blood flow response in the epigastric pedicled rat flap.  J Reconstr Microsurg . 2002;  18 61-68
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 12 Petry J J, Wortham K A. The anatomy of the epigastric flap in the experimental rat.  Plast Reconstr Surg . 1984;  74 410-413
    PubMedGoogle Scholar
  • 13 Fischer J C, Parker P M, Shaw W W. Comparison of two laser Doppler flowmeters for the monitoring of dermal blood flow.  Microsurgery . 1983;  4 164-170
    PubMedGoogle Scholar
  • 14 Place M J, Witt P, Hendricks D. Cutaneous blood-flow patterns in free flaps determined by laser Doppler flowmetry.  J Reconstr Microsurg . 1996;  12 355-358
    PubMedGoogle Scholar
  • 15 Almond N E, Wheatley A M. Measurement of hepatic perfusion in the rat by laser Doppler flowmetry.  Am J Phys . 1992;  262 G203
    PubMedGoogle Scholar
  • 16 Johnson P C. Autoregulation of blood flow.  Circ Res . 1986;  59 483-495
    CrossrefPubMedGoogle Scholar
  • 17 Krinke G J. The Laboratory Rat, 1st ed.  San Diego: Stein: Novartis Group 2000
    Google Scholar
  • 18 McKee N H, Clarke H M, Nigra C A. A study of blood flow and pressure in the vessels supplying a free flap.  Plast Reconstr Surg . 1982;  69 68-73
    CrossrefPubMedGoogle Scholar
  • 19 Reus W F, Schlenker J D. Comparison of blood flow after warm and cool ischemia in island flaps: latissimus dorsi myocutaneous and epigastric flaps in the dog.  Ann Plast Surg . 1983;  10 130-134
    PubMedGoogle Scholar
  • 20 Pang C Y, Forrest C R, Mounsey R. Pharmacologic intervention in ischemia-induced reperfusion injury in the skeletal muscle.  Microsurgery . 1993;  14 176-182
    CrossrefPubMedGoogle Scholar
  • 21 Hopper R A, Forrest C R, Xu H, et.al. Role and mechanism of PKC in ischemic preconditioning of pig skeletal muscle against infarction.  Am J Physiol Regul Integr Comp Physiol . 2000;  279 R666
    PubMedGoogle Scholar