Vascular resistance in human muscle flaps

R. C. Mahabir, J. S. Williamson, N. J. Carr, D. J. Courtemanche

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Important differences in free muscle flap survival have been reported in the setting of long arterial and venous vein grafts. The authors provide insight into the etiology of flap failure by addressing the following question: Do differences in flap type result in clinically significant different vascular resistances and consequently anastomotic patency? A total of 15 human flaps were studied intraoperatively: 9 gracilis, 3 rectus abdominis, and 3 latissimus dorsi. The muscle was isolated on a single pedicle and hemodynamic stability was ensured. The venous pedicle was then divided. A timed collection of effluent was used to determine flow. Vascular resistance was calculated by dividing the change in pressure by the flow, and standardizing this for temperature and hematocrit. Average vascular resistance and standard deviation for the gracilis, rectus, and latissimus flaps was 10.34 ± 7.77 mmHg per milliliter per minute, 2.79 ± 1.50 mmHg per milliliter per minute, and 3.17 ± 1.05 mmHg per milliliter per minute respectively. An inverse relationship between muscle vascular resistance and flap mass was found (p < 0.001). This indicates that larger muscles have less vascular resistance. The decreased resistance gives rise to higher flow rates and, as a result, potentially improved vein graft patency. The clinical implication is that a larger flap should be used when high flow-through is critical. The role of flap vascular territory makeup continues to be pursued.

Original languageEnglish (US)
Pages (from-to)148-152
Number of pages5
JournalAnnals of Plastic Surgery
Volume47
Issue number2
StatePublished - 2001
Externally publishedYes

Fingerprint

Vascular Resistance
Muscles
Veins
Transplants
Rectus Abdominis
Superficial Back Muscles
Free Tissue Flaps
Hematocrit
Blood Vessels
Hemodynamics
Pressure
Temperature

ASJC Scopus subject areas

  • Surgery

Cite this

Mahabir, R. C., Williamson, J. S., Carr, N. J., & Courtemanche, D. J. (2001). Vascular resistance in human muscle flaps. Annals of Plastic Surgery, 47(2), 148-152.

Vascular resistance in human muscle flaps. / Mahabir, R. C.; Williamson, J. S.; Carr, N. J.; Courtemanche, D. J.

In: Annals of Plastic Surgery, Vol. 47, No. 2, 2001, p. 148-152.

Research output: Contribution to journalArticle

Mahabir, RC, Williamson, JS, Carr, NJ & Courtemanche, DJ 2001, 'Vascular resistance in human muscle flaps', Annals of Plastic Surgery, vol. 47, no. 2, pp. 148-152.
Mahabir RC, Williamson JS, Carr NJ, Courtemanche DJ. Vascular resistance in human muscle flaps. Annals of Plastic Surgery. 2001;47(2):148-152.
Mahabir, R. C. ; Williamson, J. S. ; Carr, N. J. ; Courtemanche, D. J. / Vascular resistance in human muscle flaps. In: Annals of Plastic Surgery. 2001 ; Vol. 47, No. 2. pp. 148-152.
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