Chapter 4 entire flap is supplied by the deep inferior epigastric vessels which lead to the categorization of the flap zone (I–IV). After successful transplantation, LDF was measured hourly up to 5 hours after reperfusion. From the first to the fourth postoperative day LDF was measured three times a day (Table 4.2). All data are presented as mean values ± SD. The SPSS program was used for statistical analysis. Repeated measures ANOVA was used for analysis of all the repeated measurements. Mann‐Whitney U test was used for analysis of the quantitative parameters. Fisher's exact test was used for categorical data. A P value (two‐ tailed) was considered statistically significant. Table 4.2 Materials and methods. 0‐24 hours (day 0) Day +1 Day +2 Day +3 Day +4 Surgery Recovery Blood pressure M15b Hc ‐ ‐ ‐ ‐ Heart rate M15b Hc ‐ ‐ ‐ ‐ Temperature (patient) M15b Hc Hc H2 ‐ ‐ Temperature (flap) ‐ Hc Hc H2 ‐ ‐ Temperature (environment) Cd (21ºC) Cd (21ºC) NCe NCe NCe NCe Standard Controls1 ‐ Hc Hc H2f H2f D3 Laser doppler flowmetry FOPa, Ih & HR1i HR2‐5j D3g D3g D3g D3g Vasoactive medication NSk NUl NUl NUl NUl NUl 1 Standard controls include: Ultrasound doppler of perforators within the flap, skin colour and capillary refill. a FOP = LDF measurement prior to division of the vascular pedicle. At this point the entire flap is supplied by the DIE vessels which lead to the categorization of the flap zone (I‐IV). # Statistical analysis was performed with these separate measurements. In graphs mean daily values are shown in order to facilitate the data overview. bM15= every 15 minutes, cH= every hour, Cd= Controlled, NCe= not controlled, H2f= every 2 hours, D3g= 3 times a day, Ih=Ischemia, HR1i= 1 hour after ischemia, HR2‐5j = hourly measurements after reperfusion. NSk= not significant, NUl= not used Results Mean age at the time of operation was 47.7 (±7.7) years and mean BMI was 26.1 (±3.4) (Table 4.2). After adaptation of the abdominal flap, the mean weight of flap used for breast reconstruction was 800 (±221) g. The measurement location of both measurement sites remained in the reconstructed breast in all patients. An average of 85% (±14%) of the original abdominal flap weight was used for breast reconstruction. One hundred per cent of the flap was used for reconstruction in five cases (two of these patients experienced PFL). Mean flap ischemia time was 54 (±22) min (Table 4.3). 60
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