A study of perfusion of the distal free-TRAM flap using laser Doppler flowmetry

SummaryThe aim of this study was to characterise microcirculatory changes in the distal part of a flap and to evaluate whether measurement of the microcirculation may predict flap complications (FC).In this prospective study, 30 patients undergoing a delayed breast reconstruction were included. Perioperative data were recorded and with the laser Doppler flowmetry (LDF; Perimed®) blood flow was recorded in the central part (zone I) and the distal part (zone IV) of the flap.A lower blood flow was observed in zone IV of patients with flap complications compared to patients without flap complications (P = 0.013). In addition, LDF demonstrated different flow trends in zone I compared to zone IV indicating a delayed opening of the choke vessels connecting the angiosomes in the distal part of the flap.The LDF has proven to be a useful investigative tool to monitor microcirculatory changes. In future studies it will be used to evaluate interventions aimed at decreasing distal ischaemia and reducing flap complications.