• Andreas S Heitland, Martha Markowicz, Eva Koellensperger, Felix Schoth, Axel-Mario Feller, and Norbert Pallua.
• Department of Plastic Surgery, Hand Surgery, Burn Unit, University Hospital Aachen, Aachen University of Technology, Aachen, Germany. dr-heitland@t-online.de
• Ann Plast Surg. 2005 Aug 1; 55 (2): 117-21.

ObjectiveOur objective was to assess the hemodynamic differences in free DIEP (deep inferior epigastric artery perforator flap), S-GAP (superior gluteal artery perforator flap) flaps versus TRAM (transverse rectus abdominis muscle) flaps and to analyze any perfusion change due to perforator dissection (study 1). To examine the hypothesis as to whether flap perfusion is maintained through the pedicle (study 2), we also compared short- and long-term DIEP flap perfusion.Material And MethodsBlood volume flow, velocity, and diameter of the donor and recipient vessels of 4 TRAM flaps, 5 S-GAP flaps, and 17 DIEP flaps were examined preoperatively on day 5 and also 18 months postoperatively using duplex ultrasound.ResultsThe greatest volume flow and velocity are measured in the TRAM flaps, followed by S-GAP and DIEP flaps. Blood flow in the musculocutaneous and perforator flaps is twice as great as in the donor vessels, which is proof of flap hyperperfusion.SummaryThe minimum perfusion requirement is easily satisfied in musculocutaneus and free perforator flaps. In the long term, DIEP flap perfusion increases 13%, which assumes that DIEP flap perfusion is maintained on the pedicle.

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