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J Reconstr Microsurg 2017; 33(01): 032-039
DOI: 10.1055/s-0036-1588004
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Effects of Tissue Component Volumes on Vascular Resistance in Free Flaps

Masashi Ono
1   Department of Plastic and Reconstructive Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
2   Department of Plastic and Reconstructive Surgery, Gifu Prefectural Central Medical Center, Gifu, Japan
,
Keisuke Takanari
1   Department of Plastic and Reconstructive Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
,
Kazuhiro Toriyama
1   Department of Plastic and Reconstructive Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
,
Shunjiro Yagi
1   Department of Plastic and Reconstructive Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
,
Katsumi Ebisawa
1   Department of Plastic and Reconstructive Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
,
Hisashi Sawamura
1   Department of Plastic and Reconstructive Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
,
Miki Kambe
1   Department of Plastic and Reconstructive Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
,
Kenta Murotani
3   Division of Biostatistics, Center for Advanced Medicine and Clinical Research, Nagoya University Hospital, Nagoya, Japan
,
Yuzuru Kamei
1   Department of Plastic and Reconstructive Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
› Author Affiliations
Further Information

Publication History

31 October 2015

07 July 2016

Publication Date:
05 September 2016 (online)

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Abstract

Background A successful free flap transfer is achieved, in part, by having a thorough understanding of vascular anatomy and blood flow dynamics. We previously reported that vascular resistance differs by type of free flap. To test the hypothesis that the difference reflects the proportion of tissue components within free flaps, we calculated blood flow and vascular resistance for free flaps in which we determined the volume of each tissue component.

Methods Measurements and calculations were made for 40 free flap transfers performed at our hospital: 7 radial forearm flaps, 14 anterolateral thigh flaps, and 19 rectus abdominis myocutaneous flaps.

Results The vascular resistance of free flaps was inversely related to the volume of each tissue component. Univariate regression analysis revealed that muscle volume correlated most closely with resistance (r = 0.881), followed by skin (r = 0.622), and fat (r = 0.577). Multiple regression analysis confirmed the relationship between combined muscle and fat volume and resistance (R 2 = 0.865).

Conclusions A strong inverse correlation exists between vascular resistance and combined muscle and fat tissue volume in flaps. It may be helpful to consider these relationships when making decisions regarding choice of free flap and recipient vessels.

Keywords

vascular resistance - tissue components in free flaps - vascular anatomy
 

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