Abstract
Pedunculated cutaneous or myocutaneous flaps are still often used in head and neck reconstructive surgery even, although recently a free flap technique with microvascular anastomosis has been recommended. It is well known that the survival of such pedunculated flaps depends on the microvascular blood flow perfusing them, which is in turn affected by platelet activities such as aggregation and release reactions. In the present study, we measured the blood flow in pedunculated flaps used for reconstruction following the extirpation of head and neck tumors, and we examined its relationship to platelet activity. We also examined the effect of a prostacyclin (PGIZ) derivative (beraprost sodium, 120 mg/day) administered for 14 days after surgery upon blood flow in the flaps.
The relative blood flow in the flaps generally decreased to a minimum on the third postoperative day. Corresponding to this decrease in blood flow, serum PF4 and j3-TG levels, which indicate platelet activity, appeared to increase to a maximum at the same time and to return to nearly the preoperative level toward the 7th postoperative day. When beraprost sodium was given, the postoperative increases in serum PF4 and jS-TG levels were significantly lower than in those who did not receive beraprost sodium. Thus, the prostacyclin derivative is considered to be effective in improving the blood flow in pedunculated flaps by suppressing platelet activity.
