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Forehead flap perfusion monitored by laser speckle contrast imaging – importance of flap length and thickness

Berggren, Johanna LU ; Ottosson, Jens Nääv LU ; Albinsson, John LU ; Sheikh, Rafi LU orcid ; Merdasa, Aboma LU and Tenland, Kajsa LU (2024) In JPRAS Open
Abstract
Purpose: Forehead flaps are commonly used in oculoplastic surgery to cover defects after tumor excision. Blood perfusion is vital for flap survival. The aim of this study was to monitor the perfusion in forehead flaps and investigate the impact of flap length and thickness. Methods: Nineteen forehead flaps in patients undergoing direct brow lift were studied. Perfusion was monitored using laser speckle contrast imaging, immediately after raising flaps consisting of epidermis, dermis, and subcutaneous tissue, and after removing the subcutaneous tissue resulting in a thin flap. Results: Perfusion decreased gradually along the length; the mean value being 44% at 5 mm and 26% at 15 mm from the base, in thick flaps. Perfusion was significantly... (More)
Purpose: Forehead flaps are commonly used in oculoplastic surgery to cover defects after tumor excision. Blood perfusion is vital for flap survival. The aim of this study was to monitor the perfusion in forehead flaps and investigate the impact of flap length and thickness. Methods: Nineteen forehead flaps in patients undergoing direct brow lift were studied. Perfusion was monitored using laser speckle contrast imaging, immediately after raising flaps consisting of epidermis, dermis, and subcutaneous tissue, and after removing the subcutaneous tissue resulting in a thin flap. Results: Perfusion decreased gradually along the length; the mean value being 44% at 5 mm and 26% at 15 mm from the base, in thick flaps. Perfusion was significantly lower in thin flaps, being 13% measured 15 mm from the flap base (p<0.0024). Perfusion was better preserved in thick than in thin flaps. Very low perfusion was observed 16.7 mm (16.0-17.3 mm) from the base in thick flaps, and from 10.2 mm (9.8-10.6 mm) from the base in thin flaps (p<0.0001).
Conclusions: Flap thickness is important in maintaining adequate blood perfusion and thus increasing the probability of flap survival. This may be particularly important in long flaps and in patients with impaired microcirculation. (Less)
Abstract (Swedish)

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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
Blood flow, perfusion monitoring, flaps, flap thinning
in
JPRAS Open
publisher
Elsevier
ISSN
2352-5878
DOI
10.1016/j.jpra.2024.03.006
language
English
LU publication?
yes
id
2fea515f-22d2-4b6e-b209-dbfc61672c65
date added to LUP
2024-04-02 14:02:52
date last changed
2024-04-02 14:30:27
@article{2fea515f-22d2-4b6e-b209-dbfc61672c65,
  abstract     = {{Purpose: Forehead flaps are commonly used in oculoplastic surgery to cover defects after tumor excision. Blood perfusion is vital for flap survival. The aim of this study was to monitor the perfusion in forehead flaps and investigate the impact of flap length and thickness. Methods: Nineteen forehead flaps in patients undergoing direct brow lift were studied. Perfusion was monitored using laser speckle contrast imaging, immediately after raising flaps consisting of epidermis, dermis, and subcutaneous tissue, and after removing the subcutaneous tissue resulting in a thin flap. Results: Perfusion decreased gradually along the length; the mean value being 44% at 5 mm and 26% at 15 mm from the base, in thick flaps. Perfusion was significantly lower in thin flaps, being 13% measured 15 mm from the flap base (p&lt;0.0024). Perfusion was better preserved in thick than in thin flaps. Very low perfusion was observed 16.7 mm (16.0-17.3 mm) from the base in thick flaps, and from 10.2 mm (9.8-10.6 mm) from the base in thin flaps (p&lt;0.0001).<br/>Conclusions: Flap thickness is important in maintaining adequate blood perfusion and thus increasing the probability of flap survival. This may be particularly important in long flaps and in patients with impaired microcirculation.}},
  author       = {{Berggren, Johanna and Ottosson, Jens Nääv and Albinsson, John and Sheikh, Rafi and Merdasa, Aboma and Tenland, Kajsa}},
  issn         = {{2352-5878}},
  keywords     = {{Blood flow; perfusion monitoring; flaps; flap thinning}},
  language     = {{eng}},
  month        = {{03}},
  publisher    = {{Elsevier}},
  series       = {{JPRAS Open}},
  title        = {{Forehead flap perfusion monitored by laser speckle contrast imaging – importance of flap length and thickness}},
  url          = {{http://dx.doi.org/10.1016/j.jpra.2024.03.006}},
  doi          = {{10.1016/j.jpra.2024.03.006}},
  year         = {{2024}},
}