Advanced

Blood Perfusion in Human Eyelid Skin Flaps Examined by Laser Speckle Contrast Imaging-Importance of Flap Length and the Use of Diathermy

Nguyen, Cu Dinh LU ; Hult, Jenny LU ; Sheikh, Rafi LU ; Tenland, Kajsa LU ; Dahlstrand, Ulf LU ; Lindstedt, Sandra LU and Malmsjö, Malin LU (2017) In Ophthalmic Plastic and Reconstructive Surgery
Abstract

PURPOSE: It is well known that blood perfusion is important for the survival of skin flaps. As no study has been conducted to investigate how the blood perfusion in human eyelid skin flaps is affected by the flap length and diathermy, the present study was carried out to investigate these in patients.

METHODS: Fifteen upper eyelids were dissected as part of a blepharoplastic procedure, releasing a 30-mm long piece of skin, while allowing the 5 mm wide distal part of the skin to remain attached, to mimic a skin flap (hereafter called a "skin flap"). Blood perfusion was measured before and after repeated diathermy, using laser speckle contrast imaging.

RESULTS: Blood perfusion decreased from the base to the tip of the flap: 5... (More)

PURPOSE: It is well known that blood perfusion is important for the survival of skin flaps. As no study has been conducted to investigate how the blood perfusion in human eyelid skin flaps is affected by the flap length and diathermy, the present study was carried out to investigate these in patients.

METHODS: Fifteen upper eyelids were dissected as part of a blepharoplastic procedure, releasing a 30-mm long piece of skin, while allowing the 5 mm wide distal part of the skin to remain attached, to mimic a skin flap (hereafter called a "skin flap"). Blood perfusion was measured before and after repeated diathermy, using laser speckle contrast imaging.

RESULTS: Blood perfusion decreased from the base to the tip of the flap: 5 mm from the base, the perfusion was 69%, at 10 mm it was 40%, at 15 mm it was 20%, and at 20 mm it was only 13% of baseline values. Diathermy further decreased blood perfusion (measured 15 mm from the base) to 13% after applying diathermy for the first time, to 6% after the second and to 4% after the third applications of diathermy.

CONCLUSIONS: Blood perfusion falls rapidly with distance from the base of skin flaps on the human eyelid, and diathermy reduces blood perfusion even further. Clinically, it may be advised that flaps with a width of 5 mm be no longer than 15 mm (i.e., a width:length ratio of 1:3), and that the use of diathermy should be carefully considered.

(Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
Journal Article
in
Ophthalmic Plastic and Reconstructive Surgery
publisher
Lippincott Williams and Wilkins
ISSN
1537-2677
DOI
10.1097/IOP.0000000000001010
language
English
LU publication?
yes
id
c6a30dca-227f-4462-af97-1eb8567bacfb
date added to LUP
2017-11-16 09:54:24
date last changed
2017-11-16 11:30:44
@article{c6a30dca-227f-4462-af97-1eb8567bacfb,
  abstract     = {<p>PURPOSE: It is well known that blood perfusion is important for the survival of skin flaps. As no study has been conducted to investigate how the blood perfusion in human eyelid skin flaps is affected by the flap length and diathermy, the present study was carried out to investigate these in patients.</p><p>METHODS: Fifteen upper eyelids were dissected as part of a blepharoplastic procedure, releasing a 30-mm long piece of skin, while allowing the 5 mm wide distal part of the skin to remain attached, to mimic a skin flap (hereafter called a "skin flap"). Blood perfusion was measured before and after repeated diathermy, using laser speckle contrast imaging.</p><p>RESULTS: Blood perfusion decreased from the base to the tip of the flap: 5 mm from the base, the perfusion was 69%, at 10 mm it was 40%, at 15 mm it was 20%, and at 20 mm it was only 13% of baseline values. Diathermy further decreased blood perfusion (measured 15 mm from the base) to 13% after applying diathermy for the first time, to 6% after the second and to 4% after the third applications of diathermy.</p><p>CONCLUSIONS: Blood perfusion falls rapidly with distance from the base of skin flaps on the human eyelid, and diathermy reduces blood perfusion even further. Clinically, it may be advised that flaps with a width of 5 mm be no longer than 15 mm (i.e., a width:length ratio of 1:3), and that the use of diathermy should be carefully considered.</p>},
  author       = {Nguyen, Cu Dinh and Hult, Jenny and Sheikh, Rafi and Tenland, Kajsa and Dahlstrand, Ulf and Lindstedt, Sandra and Malmsjö, Malin},
  issn         = {1537-2677},
  keyword      = {Journal Article},
  language     = {eng},
  month        = {10},
  publisher    = {Lippincott Williams and Wilkins},
  series       = {Ophthalmic Plastic and Reconstructive Surgery},
  title        = {Blood Perfusion in Human Eyelid Skin Flaps Examined by Laser Speckle Contrast Imaging-Importance of Flap Length and the Use of Diathermy},
  url          = {http://dx.doi.org/10.1097/IOP.0000000000001010},
  year         = {2017},
}