• Acta oto-laryngologica · Jul 2011

    Comparative Study

    Blood pressure and free flap oxygenation in head and neck cancer patients.

    • Aleksi Schrey, Ilpo Kinnunen, Tero Vahlberg, Heikki Minn, Reidar Grénman, Markku Taittonen, and Kalle Aitasalo.
    • Department of Otorhinolaryngology - Head and Neck Surgery, Turku University Hospital, Finland. aleksi.schrey@tyks.fi
    • Acta Otolaryngol. 2011 Jul 1;131(7):757-63.

    ConclusionThis study suggests that although oxygen partial pressure in tissue (p(ti)O(2)) measurement is a feasible method for continuous postoperative monitoring of free flaps, low correlation between blood pressure (BP) and p(ti)O(2) might predict compromised overall outcome. Thus, it is of utmost importance to keep the BP optimal for adequate perfusion of re-anastomosed tissue transfers.ObjectiveOptimal BP is an important factor in assuring adequate blood flow in a free flap. Tissue oxygenation in free flaps as a postoperative monitoring target is in routine clinical use in some clinics. Correlation between p(ti)O(2) and systemic BP was investigated.MethodsTen consecutive patients underwent resection of head and neck squamous cell carcinoma followed by microvascular reconstruction with a free microvascular flap. P(ti)O(2) of each flap was continuously monitored for 3 postoperative days with a polarographic measurement system. BP was measured invasively and continuously during the operation and during the first postoperative day at the intensive care unit. The correlation coefficient between p(ti)O(2) and BP was analysed.ResultsThe correlation coefficient between p(ti)O(2) and BP was relatively high in all patients with uneventful flap survival (r (mean) = 0.63, n = 5). In flaps with haemodynamic problems or compromised flap vitality the correlation appeared low (r(mean) = -0.02, n = 5).

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