Author/Editor		Kidrič-Sivec, Urška
Title		Prekrvitev prostih režnjev s trebuha za rekonstrukcijo dojke
Type		monografija
Place		Ljubljana
Publisher		Medicinska fakulteta
Publication year		2001
Volume		str. 47
Language		slo
Abstract		Reconstruction of the female breast following mastectomy has become common place. The "gold standard" for free tisue transver in breast reconstruction is the lower abdominal skin and fat. This tissue can be transferred onto the chest wall using three vascular axes. These are the deep inferior epigastric artery, a perforator of the deep inferior epigastric artery or the superficial inferior epigastric artery. The selection for the flap is now based on the diameter of the vessel. Altrough the free flaps from the abdomen are routine in breast reconstruction, we do not know much of their haemodinamics. We divide the circularity of the free flaps in to four zones in which the circularuty in zone IV can be problematic. The aim of research consist in evaluation of a reliable method concerning the haemodynamic parameters of the free flap that would allow us to determinate preoperativly the optimal donor vessel for reconstuctive free flap surgery. At ten (10) patients that were operated for breast reconstruction with the free flap from the abdominal wall we determinate and map the flow trough the vessel with colorduplex-imaging and we determinante the dermal circulation in all four zones of the free flap before, during and after operation with laser Doppler. Altrought the haemodynamic parameters of the donor vessels were not decisive in the selection of the free flap we were able to reduce the operating time due to preoperativly locating the superficial inferior epigastric artery and the perforators of the deep inferior epigastric artery. In the dermal circulatinon in zones I-III the reactive hyperaemia appered with the paek at the end of operation and than returning to the preoperative values. Only in zone I we were observing the increasing of the skin blood flow due to vasodilatation of the denervated vessels in the fourth postoperative day. (Abstract truncated at 2000 characters)
Descriptors		MASTECTOMY MAMMAPLASTY SURGICAL FLAPS ABDOMINAL MUSCLES SKIN ULTRASONOGRAPHY, DOPPLER, DUPLEX LASER-DOPPLER FLOWMETRY EPIGASTRIC ARTERIES HYPEREMIA