Delay procedureおよびsuperdrainageを併用した逆行性浅腓腹動脈皮弁におけるTcpCO₂モニターの使用経験

抄録

　The reverse superficial sural artery flap is highly useful for reconstructing small skin defects in the distal lower leg and hindfoot. However, this flap is prone to circulatory instability because it relies on retrograde blood flow through small-caliber feeding vessels and has a blind-ended venous system. To address these issues, a delay procedure, in which flap transfer is performed in two stages, and superdrainage, involving an anastomosis of the small saphenous vein to a recipient vein at the defect site, have been proposed.
　In this study, we evaluated the usefulness of these two techniques using transcutaneous carbon dioxide (TcpCO₂) monitoring, which enables noninvasive and continuous assessment of tissue perfusion.
　Our results suggest that superdrainage may contribute to the stabilization of flap hemodynamics. Furthermore, in some cases treated with superdrainage, the delay procedure may be omitted.
　TcpCO₂ monitoring may serve as a useful tool for determining whether to proceed to the next stage at each step of treatment.