Clinical Physiology of Circulation

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


Microcirculation and oxygen regime of skin flap tissues

Authors: Bagyan A.R.1, Malinin A.A.1, Tsygankov Yu.M.1, Chomaeva A.A.2

Company:
1 Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow, Russian Federation
2 Treatment and Rehabilitation Center, Cherkessk, Russian Federation

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DOI: https://doi.org/10.24022/1814-6910-2024-21-1-56-68

UDC: 616-003.93

Link: Clinical Physiology of Blood Circulaiton. 2024; 21 (1): 45-55

Quote as: Bagyan A.R, Malinin A.A., Tsygankov Yu.M., Chomaeva A.A. Microcirculation and oxygen regime of skin flap tissues. Clinical Physiology of Circulation. 2024; 21 (1): 56–68 (in Russ.). DOI: 10.24022/1814-6910-2024-21-1-56-68

Received / Accepted:  15.02.2024 / 04.03.2024

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Abstract

Objective. To study the oxygen regime of tissues on various models of blood supply to skin flaps in the experiment as a factor in predicting the state of its viability.

Material and methods. Experimental studies were conducted on 23 white rats. To achieve the goal, 4 experimental models of a skin flap were created with conditions of its engraftment or death. The study of the oxygen regime of tissues was carried out on an oximeter TCM 400 from Radiometer (Denmark), which is designed for transcutaneous measurement of oxygen tension (TcPO2) in capillary blood. Studies were carried out for 14 days after the operation until the visual determination of the outcome of the operation.

The design of the experiment consisted in studying the oxygen regime of tissues at rest and after oxygen load depending on the state of blood supply to the tissues of the skin flap in dynamics to determine quantitative criteria for predicting its viability or necrosis, which predetermined the surgical tactics of treatment.

Results. It has been established that the oxygen regime indices in the skin flap tissues are directly dependent on the state of capillary blood flow. Zero oxygen tension values are the main indirect criterion for the absence of blood flow and a poor prognostic predictor of tissue death and necrosis. Short-term zero values of TcPO2 cannot be a criterion for tissue death. A prognostic conclusion about subsequent death of the skin flap can only be made with dynamic observation for 2–3 days after recording zero values.

The statistical significance of differences in the oxygen regime indices of the skin flap tissues for the 1st, 2nd and 4th experimental models using the Kruskal–Wallis criterion was revealed on the 2nd and 3rd days after the operation (р=0.0001).

Conclusion. As a result, the dynamics of TcPO2 indicators is significant on the 2–3 day of the study for predicting the viability of the skin flap and can be used in the clinic.


About Authors

  • Arut R. Bagyan, Postgraduate; ORCID
  • Aleksandr A. Malinin, Dr. Med. Sci., Chief Researcher; ORCID
  • Yuriy M. Tsygankov, Cand. Med. Sci., Researcher, Cardiovascular Surgeon; ORCID
  • Aida A. Chomaeva, Cand. Med. Sci., Surgeon; ORCID

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