Floor plan - 2013 Annual Meeting - American Association for Hand ...

Postoperative Changes in Blood Velocity Following Microvascular Free Tissue Transfer
Institution where the work was prepared: University of Texas M. D. Anderson Cancer Center, Houston, TX, USA
Olubunmi Ogunleye, MD1; Michael J. Miller, MD2; Craig J. Hartley, PhD3; Matthew M. Hanasono, MD1; (1)University
of Texas M. D. Anderson Cancer Center, (2)Ohio State University, (3)Baylor College of Medicine
BACKGROUND:
Microvascular free flap surgery is routine today, but little is known about its physiology. Quantifying blood velocity during the postoperative
period would help inform the surgeon as to when microvascular thrombosis, which is associated with low velocity states, is most likely to occur.
OBJECTIVES:
1. To quantify arterial and venous blood velocity in microvascular free flaps prior to pedicle division and after anastomosis to understand
how free tissue transfer affects blood flow through the flap. 2. To understand how arterial and venous blood velocity change during the
early postoperative period.
METHODS:
Thirty-two free flaps were performed for reconstruction of head and neck defects. During surgery, a 20 MHz needle-type Doppler was
held at a 45 degree angle to the flap artery or vein to measure blood velocity prior to pedicle division and 20 minutes after anastomosis.
A Cook-Schwartz (Cook Vascular Incorporated, Vandergrift, PA) implantable Doppler probe was then used to measure arterial
and/or venous blood velocity daily for 5 days.
RESULTS:
Free flaps included: 14 anterolateral thigh free flaps, 10 radial forearm free flaps, and 8 fibula osteocutaneous free flaps. The arterial blood
velocity was 30.3±16.2 cm/s prior to pedicle division and increased to 36.5±14.7 cm/s 20 minutes after anastomosis (p