Cutaneous blood flow in the TRAM flap

Blood flow in free micro-vascular flaps

“…In this study, we also confirmed with colour Doppler ultrasound that the deep inferior epigastric artery is larger than the superior one and that it is the main pedicle of the TRAM, as previously suggested by Tuominen et al (177).…”

“…The skin territory of the TRAM flap is divided into four zones, based on the contribution of the blood supply from the pedicle. The axial/ipsilateral side (zones I and III) to the pedicle is well vascularized but blood circulation on the random/contralateral side (zones II and IV) is less reliable (104,177). To ensure better blood flow a double pedicle technique in which both rectus abdominis muscles are included in the flap has been developed (56).…”

“…The inferior epigastric artery is the dominant supplier of blood to the flap. Clinical haemodynamic studies have shown that the free TRAM has more reliable flow (176,177) and less edge necrosis than the pedicled TRAM flap (45) or even the supercharged version (176). A larger portion of tissue can be included in the flap (40) and better aesthetic results can be achieved (45).…”

Measurement of blood flow and oxygen tension in adjacent tissues in pedicled and free flap head and neck reconstruction

“…Experimentally, Tuominen et al 6 have demonstrated, with the use of laser Doppler and TcPO 2 measurements, that blood flow in the immediate postoperative period is higher in free TRAM flaps than in pedicled flaps. In the current study, a variety of free flaps were employed, which may have contributed to the differing results.…”

“…5 Recent studies have demonstrated that free tissue transfer shows improved blood flow over pedicled flaps. 6 However, blood flow and oxygen tension in tissues adjacent to the pedicled or free flaps have not previously been evaluated. It is the purpose of this study to assess blood flow and oxygen tension in tissues adjacent to pedicled or free flaps.…”