Mathieu D, Neviere R, Pellerin P, Patenotre P, Wattel F, et al.
Plastic and reconstructive surgery. Date of publication 1993 Feb 1;volume 91(2):329-34.
1. Plast Reconstr Surg. 1993 Feb;91(2):329-34.
Pedicle musculocutaneous flap transplantation: prediction of final outcome by
transcutaneous oxygen measurements in hyperbaric oxygen.
Mathieu D(1), Neviere R, Pellerin P, Patenotre P, Wattel F.
Author information:
(1)Service d'Urgence Respiratoire, Centre Hospitalier et Universitaire, Lille,
France.
In pedicle musculocutaneous flaps, a local circulatory insufficiency with a total
or subtotal ischemia may occur and jeopardize the result of the reconstructive
surgery. Transcutaneous oxygen pressure (PtcO2) monitoring has been shown to
reflect tissue perfusion and has been advocated to predict the final outcome of
ischemic flaps. Unfortunately, under normal atmospheric conditions, this test is
not sufficiently discriminative. We evaluate the effect of hyperbaric oxygen
conditions on the efficiency of this test. Fifteen patients with pedicle
musculocutaneous flap were evaluated by clinical examination and transcutaneous
oxygen tension measurements. The final outcome was healing in 7 and failure in 8.
In order to determine the predictive value of transcutaneous oxygen tension,
measurements were done immediately after the surgical procedure. In ambient air,
neither the absolute value of transcutaneous oxygen tension (2.6 +/- 3.6 versus
11.7 +/- 12.6 torr; N.S.) nor the difference or the ratio between the
transcutaneous oxygen tension of the flap and the subclavicular reference shows
any significant difference according to the outcome (failure or success). The
same is true in normobaric oxygen. In hyperbaric oxygen, however, there is a
significant difference in transcutaneous oxygen tension between the two groups
(12 +/- 12 versus 378 +/- 385 torr; p < 0.01). A transcutaneous oxygen tension
higher than 50 torr in hyperbaric oxygen (2.5 atm abs) is the best cutoff value
to discriminate success from failure.
PMID: 8430149 [Indexed for MEDLINE]
