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Monitoring microvascular free flaps with tissue oxygen measurement and PET.

Authors:
Aleksi R Schrey Ilpo A J Kinnunen Reidar A Grénman Heikki R I Minn Kalle M J Aitasalo

Eur Arch Otorhinolaryngol 2008 Jul 30;265 Suppl 1:S105-13. Epub 2008 Jan 30.

Department of Otorhinolaryngology-Head and Neck Surgery, Turku University Central Hospital, 20521 Turku, Finland.

Tissue oxygen measurement and positron emission tomography (PET) were evaluated as methods for predicting ischemia in microvascular free flaps of the head and neck. Ten patients with head and neck squamous cell cancer underwent resection of the tumour followed by microvascular reconstruction with a free flap. Tissue oxygenation of the flap (P(ti)O(2)) was continuously monitored for three postoperative (POP) days and the blood flow of the flap was assessed using oxygen-15 labelled water and PET. In three free flaps a perfusion problem was suspected due to a remarkable drop in P(ti)O(2)-values, due to two anastomosis problems and due to POP turgor. No flap losses occurred. During the blood flow measurements with PET [mean 8.5 mL 100 g(-1) min(-1 )(SD 2.5)], the mean P(ti)O(2) of the flaps [46.8 mmHg (SD 17.0)] appeared to correlate with each other in each patient (p<0.05, n=10). Tissue oxygenation measurement is a feasible monitoring system of free flaps. The perfusion-study with PET correlates with P(ti)O(2)-measurement.

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http://dx.doi.org/10.1007/s00405-008-0585-0DOI Listing
July 2008

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