Abstract
The aim of this study was to assess intraoperatively the hemodynamic changes in the
donor vessel of free latissimus dorsi (LD) flap before and after denervation and to
analyze flow changes after flap transfer. Twenty-seven patients underwent LD muscle
microvascular reconstruction for lower-limb soft tissue defects. Measurements of blood
flow were performed intraoperatively by using a 2- to 5-mm probe ultrasonic transit-time
flowmeter around the dissected vessels. Registrations were made in the thoracodorsal
artery before and after harvesting the flap, after compressing and cutting the motor
nerve, and after anastomosis. Mean blood flow of in situ harvested thoracodorsal artery
as measured intraoperatively by transit-time flowmeter was (mean ± standard deviation)
16.6 ± 11 mL/min and was significantly increased after raising the flap to 24.0 ± 22
mL/min (p <0.05); it was 25.6 ± 23 mL/min after compressing the motor nerve and was significantly
increased after cutting the motor nerve to 32.5 ± 26 mL/min (p <0.05). A significant increase of blood flow to 28.1 ± 19 mL/min was also detected
in the thoracodorsal artery after flap transplantation with end-to-side anastomosis
(p <0.05). Vascular resistance in the thoracodorsal artery significantly decreased after
flap raising and anastomosis (from 7.5 ± 3.4 to 4.0 ± 1.9 and to 4.5 ± 2.4, respectively,
p <0.05). LD flap harvesting increases blood flow and decreases resistance in the thoracodorsal
artery, especially after denervation.
Keywords
latissimus dorsi muscle - free flap - microvascular flap - blood flow - hemodynamics
- intraoperative
