Plastic and Reconstructive Surgery

  • Per Hedén
Part of the Developments in Cardiovascular Medicine book series (DICM, volume 107)


As early as 700 B.C., reconstructive surgery of nose defects was performed by Susruta in India, and in 1597 the first publication on skin flaps was presented by the Italian Gaspare Tagliacozzi. In spite of this long history, only during the last decades has interest been aroused in the skin flap’s circulation. In fact, today it is widely accepted that increased knowledge about skin flap physiology is necessary to improve clinical techniques and to reduce the complication rate in this type of surgery. Because the major cause of flap failure is inadequate blood supply, an accurate assessment of tissue perfusion is of great importance in plastic and reconstructive surgery. However, down through the years the needs and indications for blood flow measurements have changed. At first, efforts were concentrated on estimating the revascularization process and on determining the correct time for the division of flaps destined for transfer as tubes to distant recipient sites in some multistage procedure. When microsurgery was introduced in reconstructive surgery in the early 1970s, a direct one-stage transfer of a flap to a distant recipient area became possible by means of microanastomoses of both the supplying and the draining blood vessels. With this technique, adequate assessment of the flap blood flow became even more crucial, since occlusion of microvascular anastomoses must be diagnosed and rectified promptly to ensure survival of such free flaps.


Skin Flap Free Flap Venous Occlusion Myocutaneous Flap Pedicle Flap 
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© Springer Science+Business Media New York 1990

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  • Per Hedén

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