Background:
Intraoperative and postoperative monitoring of microcirculation could provide essential information on flaps’ survival and viability after ischemia-reperfusion (I/R). Our aim was to investigate whether I/R of latissimus dorsi musculocutaneous flaps (LDMF) affects the microcirculatory and micro-rheological parameters, and to analyze the possible predictive value of the intraoperatively performed tests.

Material and Methods:
In two groups of anesthetized male CD rats, LDMF were made bilaterally. In Group I (n=6) the left flap was sutured back after 2h, while on the contralateral side just after its preparation. In Group II (n=6) the flap pedicle was clamped for 2h, otherwise the same protocol was used. Over the skin (proximal-middle-distal region) laser Doppler tests were done before/after the preparation, during the applied protocol and in the postoperative period. The extent of necrotic areas was also determined by photo analysis. Hematological and hemorheological examinations were carried out.

Result:
In Group I, 2h flap-immobilization resulted in decreased skin microcirculatory values. After ischemia in Group II, the values almost completely normalized except for the apical region. Skin necrosis was observed along the flap edges and in two cases on the whole flap. In these flaps, retrospectively, the intraoperative microcirculatory values remained below the average. Erythrocyte aggregation and deformability did not show obvious difference.

Conclusion:
Two-hour flap I/R caused more prominent deterioration in the local microcirculation than in the micro-rheological parameters. The intraoperative observation of microcirculation may have significant relevance in the prediction of flaps’ viability. (Grants: Bridging Fund-2012, Postgraduate Scholarship A2-ACSJD-12-0380)