Use of laser Doppler flowmetry to determine blood flow in and viability of island axial pattern skin flaps in rabbits

Perfusion and viability of island axial pattern skinflaps were tested in 37 healthy New Zealand white rabbits, using laser Doppler monitoring of blood flow in the capillary loops and the subpapillary plexus of the dermis. Skin flaps, selected on the basis of the caudal superficial epigastric vein and artery, were lifted and replaced in their original locus after selective occlusion of their vascular pedicles. Subjects were allotted into groups: control group (n = 10); arterial occlusion (n = 7); venous occlusion (n = 10); and arterial and venous occlusion (n = 10). The rabbits were monitored from 48 hours before surgery until euthanasia 48 to 72 hours after replacement of the flap. Flap viability was assessed on a clinical basis, using a comparative scoring method based on a numeric scale. The degree of necrosis in histologic sections was evaluated, using a scoring system. Laser Doppler measurements were obtained on 3 consecutive days before surgery, to establish the normal basal blood flow in the skin. Postsurgical measurements were obtained at 2-hour intervals for the first 8 hours and at 24, 48, and 72 hours after surgery. Measurements of basal blood flow varied significantly (P < 0.05) from site to site on the surface of individual flaps and over time. When laser Doppler flowmetric (LDF) measurements from 6 sites on a flap were used as a measure of laser Doppler flow for the total flap, there was no significant difference between contralateral flap areas outlined on the abdomen of the rabbits. Temporal variations over 3 days for each rabbit or among rabbits were not significant. The LDF measurements detected acute vascular occlusion when compared with the controls, and were able to differentiate between control and arterial occlusion groups, control and venous occlusion groups, control and arterial and venous occlusion groups, arterial and venous occlusion groups, venous and arterial and venous occlusion groups (P < 0.05), but not between arterial and arterial and venous occlusion groups. Evaluation of LDF values at 4 hours proved to be a better predictor than clinical assessment at 4 or 8 hours in evaluating skin flap viability.