Influence of a delay on latissimus dorsi muscle flap blood flow

Isoda, Susumu; Yamaguchi, Yoshimi; Jin, Yasuyuki; Walters, Henry L.; Kondo, Jiro; Matsumoto, Akihiko

doi:10.1016/0003-4975(94)00954-6

Cited by 30 publications

(8 citation statements)

References 13 publications

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“…Many studies have been conducted to answer this question. [ 21 22 23 24 ] The amount of vascularity increases required for an adequate delay still remains as an important question. This will depend on many variables as well as the delay technique.…”

Section: Discussionmentioning

confidence: 99%

Comparison of subdermal and perforator delay techniques on a rat flap model

Altınel

Biltekin

Serin

et al. 2018

Indian J Plast Surg

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Background:In this study, we investigated the subdermal and perforator delay phenomena as a method to improve flap survival.Materials and Methods:In this experimental study, we used 24 rats in three groups. In the control group, the dorsal flaps were elevated and reinserted back to their place. In the experimental groups, we practiced the delay phenomena with two different techniques. In the first experimental group, cranial and lateral side incisions were performed; however, the flaps were not cut-off from the underlying fascia. In the second experimental group, we placed a silicon sheet under the planned flap to cut-off the circulation from the perforator vessels. Four weeks after the delay procedure, the flaps were raised completely and reinserted back to their place.Results:The average of necrotic area in the control group was 21.9% (±7.70). There was no necrosis in both experimental groups (P < 0.0001). Histological examination revealed that collagen density in both of the experimental groups was increased in comparison to the control group, it has only been found a significant first experimental group (P = 0.0315). We have not found any significant difference in lymphocyte density between the groups. Angiographic imaging has showed an increase in the vascular density in the flaps of the first experimental group.Conclusion:We believe that both of these delay techniques can be adapted to clinical applications and used safely to increase flap survival.

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Section: Discussionmentioning

confidence: 99%

Comparison of subdermal and perforator delay techniques on a rat flap model

Altınel

Biltekin

Serin

et al. 2018

Indian J Plast Surg

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“…There have been other approaches to the restoration of the distal blood supply. These include a true vascular delay of 10–18 days prior to mobilization of the muscle,3, 4, 9, 15 and the use of pharmacological agents such as salbutamol,37 vasodilators,31, 33 and angiogenic growth factors 8, 19…”

Section: Discussionmentioning

confidence: 99%

Improved viability of latissimus dorsi muscle grafts after electrical prestimulation

et al. 2002

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Surgical mobilization of the latissimus dorsi muscle (LDM) produces fiber degeneration, particularly in the distal part of the graft, that may compromise its function in clinical applications such as dynamic cardiomyoplasty. In five rats, the left LDM was stimulated continuously at 10 HZ. After 5 weeks, vessels perforating the chest wall were divided and the left LDM was mobilized as a pedicle graft based on the thoracodorsal artery. Twenty-four hours later, animals were killed and left and right LDMs were incubated with the vital stain nitroblue tetrazolium. Five control rats underwent a similar procedure without prestimulation. Mobilization of the LDM resulted in a loss of viability in the distal third of the muscle graft. This was reduced significantly by prestimulation (P = 0.006). Blood flow to the distal LDM graft is known to be augmented by electrical stimulation in situ before mobilization; the present results show that there is an associated enhancement of viability. The clinical implications of this finding are discussed.

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“…The delay allowed us to asses the extent of damage and necrosis of the soft tissue and decrease in oedema and infection and also to asses the amount of viable tissue and to know the amount of defect to design the flaps. The division of cross leg flaps was done only after 3 weeks, to give sufficient time for vascularisation [2], then only the division or delaying of flap was done in centimeter by centimeter over a period of 1 week or 10 days. We did not dare to divide the flap on 1 or 2 sittings for fear of flap failure [2].…”

Section: Medial Head Of Gastrocnemius In Upper 3rd Legmentioning

confidence: 99%

“…The division of cross leg flaps was done only after 3 weeks, to give sufficient time for vascularisation [2], then only the division or delaying of flap was done in centimeter by centimeter over a period of 1 week or 10 days. We did not dare to divide the flap on 1 or 2 sittings for fear of flap failure [2]. Fascio cutaneous flaps enjoyed a surge of popularity following their description by PONTEN in 1979 [6].…”

Section: Medial Head Of Gastrocnemius In Upper 3rd Legmentioning

confidence: 99%

A study of Flap Coverage of Limbs in Orthopaedics

Chary¹,

J²,

Reddy³

2016

SJAMS

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Open / compound fractures of the limbs are very common and challenging in this modern era of industrial and road traffic accident and is a difficult task for the orthopaedic surgeon. The aim of this study is how to minimise the morbidity, mortality, incidence of amputation and other complications of fractures by way of timely intervention with different types of flap coverage of limbs. This study was carried out in the department of orthopaedics and traumatology and department of plastic surgery -Osmania General Hospital, Hyderabad during June 1996 -Feb 1999. A total no. of 68 cases of soft tissue coverage procedures were done including different varieties of flaps like split skin grafting, fascio cutaneous, muscle, cross leg, abdominal, groin and free flaps in patients of 18 -45 years of age group and more than 80% patients are males. In our study of 68 cases of reconstruction, 38 cases (55.8%) are carried out in the form of skin grafts, 16 cases (23.5%) are local flaps-muscle and fasciocutaneous flaps, 8 cases (11.7%) are cross leg flaps, 2 cases (2.9%) are abdominal flaps, 2 cases (2.9%) are groin flaps and 2 cases (2.9%) free flaps. The grading of results are assessed based on sound union of the fracture, stiffness / range of movements of neighbouring joints, amount of scar, presence / absence of DNVD and flap necrosis. We achieved excellent results in 32 cases (47.0%), good in 20 cases (29.4%), fair in 12 cases (17.7%) and poor in 4 cases (5.9%). It is very much useful by timely intervening and planning for soft tissue coverage in minimising the incidence of infection rate, decreasing the hospital stay and facilitating the congenial condition for further definitive management of fracture union. Flap coverage of the limbs has a most significant role in decreasing the morbidity, mortality and amputations of limbs due to infection of soft tissue and infected non unions.

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Influence of a delay on latissimus dorsi muscle flap blood flow

Cited by 30 publications

References 13 publications

Comparison of subdermal and perforator delay techniques on a rat flap model

Comparison of subdermal and perforator delay techniques on a rat flap model

Improved viability of latissimus dorsi muscle grafts after electrical prestimulation

A study of Flap Coverage of Limbs in Orthopaedics

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