Tissue oxygen tension in random pattern skin flaps during normovolemic hemodilution

Hansen, Ebbe Stender; Gellett, Søren; Kirkegård, Lynge; Hjortdal, Vibeke E.; Gottrup, Finn

doi:10.1016/0022-4804(89)90043-7

Cited by 8 publications

(5 citation statements)

References 14 publications

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“…However, preoperative anemia results in an increase of cardiac output and oxygen extraction to maintain tissue oxygenation as long as the intravascular volume is maintained. Therefore, anemia itself does not cause impaired tissue oxygenation in normovolemic patients [ 29 ]. We were able to confirm this fact in the multivariate analysis.…”

Section: Discussionmentioning

confidence: 99%

Influence of Shorter Duration of Prophylactic Antibiotic Use on the Incidence of Surgical Site Infection Following Colorectal Cancer Surgery

et al. 2015

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PurposeThis study aimed to identify the risk factors for surgical site infections (SSIs) in patients undergoing colorectal cancer surgery and to determine whether significantly different SSI rates existed between the short prophylactic antibiotic use group (within 24 hours) and the long prophylactic antibiotic use group (beyond 24 hours).MethodsThe medical records of 327 patients who underwent colorectal resection due to colorectal cancer from January 2010 to May 2014 at a single center were retrospectively reviewed, and their characteristics as well as the surgical factors known to be risk factors for SSIs, were identified.ResultsAmong the 327 patients, 45 patients (13.8%) developed SSIs. The patients were divided into two groups according to the duration of antibiotic use: group S (within 24 hours) and group L (beyond 24 hours). Of the 327 patients, 114 (34.9%) were in group S, and 213 (65.1%) were in group L. Twelve patients (10.5%) in group S developed SSIs while 33 patients (15.5%) in group L developed SSIs (P = 0.242). History of diabetes mellitus and lung disease, long operation time, and perioperative transfusion were independent risk factors for SSIs.ConclusionThis study shows that discontinuation of prophylactic antibiotics within 24 hours after colorectal surgery has no significant influence on the incidence of SSIs. This study also showed that history of diabetes mellitus and lung disease, long operation time, and perioperative transfusion were associated with increased SSI rates.

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Section: Discussionmentioning

confidence: 99%

Influence of Shorter Duration of Prophylactic Antibiotic Use on the Incidence of Surgical Site Infection Following Colorectal Cancer Surgery

et al. 2015

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“…This effect becomes more prominent if hematocrit levels are increased, whereas blood viscosity will be lower in the case of decreased hematocrit levels, such as in the case of hemodilution. Therefore, the impact of hemodilution on tissue perfusion will be more obvious with reduction of blood flow [ 23 ]. Our findings are consistent with this data, since hemodilution ratios of 5%, 10%, 15%, and 20% were associated with less necrotic areas in skin flaps.…”

Section: Discussionmentioning

confidence: 99%

“…The deformation of erythrocyte shape and concentration of plasma fibrinogen are other determinants of blood viscosity. These circumstances occur in cases of ischemia and acidosis, and result in an elevated rate of erythrocyte aggregation [ 23 ]. Hemodilution can restore local blood flow and tissue oxygenation, which may subsequently reverse the pathological changes in erythrocyte shape and acid-base balance [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

“…These circumstances occur in cases of ischemia and acidosis, and result in an elevated rate of erythrocyte aggregation [ 23 ]. Hemodilution can restore local blood flow and tissue oxygenation, which may subsequently reverse the pathological changes in erythrocyte shape and acid-base balance [ 23 ]. In the relevant literature, results similar to our data were reported, showing that normovolemic hemodilution was associated with improved oxygen concentrations in both subcutaneous tissue and random-pattern skin flaps [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

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Effects of Normovolemic Hemodilution on Survival of Skin Flaps: An Experimental Study

Demir

2018

Med Sci Monit

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BackgroundThe aim of this study was to investigate the effects of various ratios of hemodilution on the survival of McFarlane’s skin flaps.Material/MethodsAn experimental study was performed on 42 adult male Wistar rats (weighing 260 to 305 g) allocated to a control group without any volume loss and to 6 study groups with hemodilution ratios of 5%, 10%, 15%, 20%, 25%, and 30%. In all subjects, random-pattern McFarlane’s skin flaps were uniformly elevated and re-sutured to the donor sites. The amount of necrosis was evaluated on the 7th day postoperatively and compared among the groups.ResultsThe amounts of flap necrosis in the groups with 5%, 10%, 15%, and 20% hemodilution ratios were significantly lower than that of the control group (p<0.001). In the 25% and 30% hemodilution groups, although there was less necrosis than in the control group, the differences were not statistically significant. Hematocrit levels, which initially decreased in conjunction with the hemodilution ratios, returned to normal levels on the 7th day after the operation.ConclusionsOur results indicated that 20% or less of the total blood volume loss that may be compensated by the normovolemic hemodilution with dextran can improve flap survival.

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“…Hansen et al 21 studied the effects of normovolemic hemodilution on subcutaneous tissue oxygen tension (PscO 2 ) in canine random pattern flaps and adjacent intact skin. The PscO 2 was maintained or improved during hemodilution from a hematocrit of 40 to 14.…”

Section: Normovolemic Hemodilutionmentioning

confidence: 99%

Experimental prevention of free flap thrombosis. II: Normovolemic hemodilution for thrombosis prevention

Atchabahian

Masquelet

1996

Microsurgery

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A microvascular free flap failure model consisting of raising an epigastric groin flap on the femoral pedicle, while cutting the femoral artery, twisting it around the femoral vein and resuturing it, has been previously described. As it was being evaluated, normovolemic hemodilution as a means to prevent thrombosis was simultaneously assessed using an additional experimental group. Twenty percent of the blood mass of each rat was taken and replaced with a hydroxyethyl starch solution immediately before surgery. Only 14 out of 20 anastomoses presented with thrombosis (13 venous and one mixed), as opposed to 19 out of 20 animals operated on without hemodilution (P< 0.05). Normovolemic hemodilution appears to be an effective method of reducing microvascular free flap failure.

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Tissue oxygen tension in random pattern skin flaps during normovolemic hemodilution

Cited by 8 publications

References 14 publications

Influence of Shorter Duration of Prophylactic Antibiotic Use on the Incidence of Surgical Site Infection Following Colorectal Cancer Surgery

Influence of Shorter Duration of Prophylactic Antibiotic Use on the Incidence of Surgical Site Infection Following Colorectal Cancer Surgery

Effects of Normovolemic Hemodilution on Survival of Skin Flaps: An Experimental Study

Experimental prevention of free flap thrombosis. II: Normovolemic hemodilution for thrombosis prevention

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