A variety of factors may limit blood flow in microvascular anastomosis. Recalcitrant vasoconstriction, one of these factors, remains an occasional and difficult problem, and the resultant hypoperfusion has been thought to contribute to ultimate failure of microvascular anastomosis.
Blood flow change and blood flow recovery at the skin level following epinephrine induced vasospasm and microvascular anastomosis were evaluated in a rat orthotropic groin free flap model using a laser Doppler velocimeter.
Male Sprague-Dawley rats (N=115), weighting 300-400gm, were randomly distributed, into four major groups.
Group A (N=30) with elevation of the groin flap,
Group B (N=40) with flap elevation and epinephrine induced vasospasm,
Group C (N=40) with flap elevation and microvascular anastomtsis, were subdivided and the field around the pedicle was flooded with 0.9% saline and vasodilaters (4% lidocaine, 20% lidocaine, 3% papaverine). The blood flow change was recorded as a percentage of the control value.
Group D (N=5) with bilateral flap elevation, microvascular anastomosis was done on one side and blood flow was recorded on the other side to evaluate the systemic effect of papaverine.
The results were as follows ;
1. Group A.
In the 4% lidocaine-treated group, the blood flow at the skin level of the flap increased up to
|