Skin perfusion assessed by contrast ultrasound predicts tissue survival in a free flap model

J. P. Christiansen, H. Leong-Poi, L. R. Amiss, D. B. Drake, Sanjiv Kaul, Jonathan Lindner

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

The purpose of this study was to assess perfusion in a free skin flap model using contrast-enhanced ultrasound (CEU), and to determine if the extent of perfusion early after venous occlusion predicted long-term flap survival. Perfusion was assessed in an autologous abdominal skin flap and adjacent healthy skin in rats using CEU imaging before venous occlusion and following reflow. Perfusion assessment was possible in all flaps and quantitative measurements of microvascular blood volume (BV) and blood velocity were expressed as a ratio to that in the healthy skin. Proximal flap BV 18 h after venous occlusion was significantly greater in those that survived (n = 4) vs. those that became necrotic (n = 6) (BV ratio 0.8 ± 0.1 vs. 0.2 ± 0.1, p = 0.0001). A BV ratio of 0.5 predicted graft viability with a sensitivity and specificity of 100%. Microvascular blood velocity at 18 h was similar in grafts that survived and those that became necrotic. Qualitative assessment of perfusion by a 'blinded' observer correlated well with quantitative data and predicted flap outcome in all cases. We conclude that skin perfusion can be assessed with CEU. Perfusion 18 h following a secondary ischemic insult in a free flap accurately predicts subsequent tissue survival in this model.

Original languageEnglish (US)
Pages (from-to)315-320
Number of pages6
JournalUltrasound in Medicine and Biology
Volume28
Issue number3
DOIs
StatePublished - 2002
Externally publishedYes

Fingerprint

Tissue Survival
Free Tissue Flaps
Perfusion
blood volume
Skin
Blood Volume
occlusion
blood
Transplants
viability
rats
Ultrasonography
Sensitivity and Specificity
sensitivity

Keywords

  • Contrast
  • Flap
  • Perfusion
  • Skin
  • Ultrasound

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Skin perfusion assessed by contrast ultrasound predicts tissue survival in a free flap model. / Christiansen, J. P.; Leong-Poi, H.; Amiss, L. R.; Drake, D. B.; Kaul, Sanjiv; Lindner, Jonathan.

In: Ultrasound in Medicine and Biology, Vol. 28, No. 3, 2002, p. 315-320.

Research output: Contribution to journalArticle

Christiansen, J. P. ; Leong-Poi, H. ; Amiss, L. R. ; Drake, D. B. ; Kaul, Sanjiv ; Lindner, Jonathan. / Skin perfusion assessed by contrast ultrasound predicts tissue survival in a free flap model. In: Ultrasound in Medicine and Biology. 2002 ; Vol. 28, No. 3. pp. 315-320.
@article{a3e10e6194784ce7940e383e9f83591d,
title = "Skin perfusion assessed by contrast ultrasound predicts tissue survival in a free flap model",
abstract = "The purpose of this study was to assess perfusion in a free skin flap model using contrast-enhanced ultrasound (CEU), and to determine if the extent of perfusion early after venous occlusion predicted long-term flap survival. Perfusion was assessed in an autologous abdominal skin flap and adjacent healthy skin in rats using CEU imaging before venous occlusion and following reflow. Perfusion assessment was possible in all flaps and quantitative measurements of microvascular blood volume (BV) and blood velocity were expressed as a ratio to that in the healthy skin. Proximal flap BV 18 h after venous occlusion was significantly greater in those that survived (n = 4) vs. those that became necrotic (n = 6) (BV ratio 0.8 ± 0.1 vs. 0.2 ± 0.1, p = 0.0001). A BV ratio of 0.5 predicted graft viability with a sensitivity and specificity of 100{\%}. Microvascular blood velocity at 18 h was similar in grafts that survived and those that became necrotic. Qualitative assessment of perfusion by a 'blinded' observer correlated well with quantitative data and predicted flap outcome in all cases. We conclude that skin perfusion can be assessed with CEU. Perfusion 18 h following a secondary ischemic insult in a free flap accurately predicts subsequent tissue survival in this model.",
keywords = "Contrast, Flap, Perfusion, Skin, Ultrasound",
author = "Christiansen, {J. P.} and H. Leong-Poi and Amiss, {L. R.} and Drake, {D. B.} and Sanjiv Kaul and Jonathan Lindner",
year = "2002",
doi = "10.1016/S0301-5629(01)00523-3",
language = "English (US)",
volume = "28",
pages = "315--320",
journal = "Ultrasound in Medicine and Biology",
issn = "0301-5629",
publisher = "Elsevier USA",
number = "3",

}

TY - JOUR

T1 - Skin perfusion assessed by contrast ultrasound predicts tissue survival in a free flap model

AU - Christiansen, J. P.

AU - Leong-Poi, H.

AU - Amiss, L. R.

AU - Drake, D. B.

AU - Kaul, Sanjiv

AU - Lindner, Jonathan

PY - 2002

Y1 - 2002

N2 - The purpose of this study was to assess perfusion in a free skin flap model using contrast-enhanced ultrasound (CEU), and to determine if the extent of perfusion early after venous occlusion predicted long-term flap survival. Perfusion was assessed in an autologous abdominal skin flap and adjacent healthy skin in rats using CEU imaging before venous occlusion and following reflow. Perfusion assessment was possible in all flaps and quantitative measurements of microvascular blood volume (BV) and blood velocity were expressed as a ratio to that in the healthy skin. Proximal flap BV 18 h after venous occlusion was significantly greater in those that survived (n = 4) vs. those that became necrotic (n = 6) (BV ratio 0.8 ± 0.1 vs. 0.2 ± 0.1, p = 0.0001). A BV ratio of 0.5 predicted graft viability with a sensitivity and specificity of 100%. Microvascular blood velocity at 18 h was similar in grafts that survived and those that became necrotic. Qualitative assessment of perfusion by a 'blinded' observer correlated well with quantitative data and predicted flap outcome in all cases. We conclude that skin perfusion can be assessed with CEU. Perfusion 18 h following a secondary ischemic insult in a free flap accurately predicts subsequent tissue survival in this model.

AB - The purpose of this study was to assess perfusion in a free skin flap model using contrast-enhanced ultrasound (CEU), and to determine if the extent of perfusion early after venous occlusion predicted long-term flap survival. Perfusion was assessed in an autologous abdominal skin flap and adjacent healthy skin in rats using CEU imaging before venous occlusion and following reflow. Perfusion assessment was possible in all flaps and quantitative measurements of microvascular blood volume (BV) and blood velocity were expressed as a ratio to that in the healthy skin. Proximal flap BV 18 h after venous occlusion was significantly greater in those that survived (n = 4) vs. those that became necrotic (n = 6) (BV ratio 0.8 ± 0.1 vs. 0.2 ± 0.1, p = 0.0001). A BV ratio of 0.5 predicted graft viability with a sensitivity and specificity of 100%. Microvascular blood velocity at 18 h was similar in grafts that survived and those that became necrotic. Qualitative assessment of perfusion by a 'blinded' observer correlated well with quantitative data and predicted flap outcome in all cases. We conclude that skin perfusion can be assessed with CEU. Perfusion 18 h following a secondary ischemic insult in a free flap accurately predicts subsequent tissue survival in this model.

KW - Contrast

KW - Flap

KW - Perfusion

KW - Skin

KW - Ultrasound

UR - http://www.scopus.com/inward/record.url?scp=0036222857&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0036222857&partnerID=8YFLogxK

U2 - 10.1016/S0301-5629(01)00523-3

DO - 10.1016/S0301-5629(01)00523-3

M3 - Article

VL - 28

SP - 315

EP - 320

JO - Ultrasound in Medicine and Biology

JF - Ultrasound in Medicine and Biology

SN - 0301-5629

IS - 3

ER -