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Free flap perfusion (Perfusion pressure (MAP - main determinant of the…
Free flap perfusion
Perfusion pressure
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Transmural pressure is decreased by an increase in extravascular pressure (flap tissue does not have lymph drainage - oedema risk, haematoma, dressings, positioning)
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Vessel radius
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Vasodilation results in increased flow (anaesthesia and analgesia, normothermia)
Vasoconstriction reduces flow (hypothermia, hypovolaemia, SNS activation, resp alkalosis)
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Fundamentals
Free flaps have their circulation detached and reanastamosed distantly and are thus vulnerable to ischaemia
Flow is laminar and can be described with Hagen Poiseulle equation:
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