Chapter 4 influencing risk factors on the occurrence of FC revealed no statistical difference in this study (Table 4.4). No significant differences were noted in the hemodynamics (blood pressure and heart rate) and room temperature (measured every 15 min) during the first 24 h after surgery when comparing patients with FC compared to those without FC (data not shown). After reconstruction, the flaps with FC seemed to have a lower skin flap temperature (Figure 4.2; P=0.151). Figure 4.2 Flap skin temperature. After reconstruction, the flaps with FC seemed to have a lower skin flap temperature (not significant; P=0.151). This slightly lower skin flap temperature is probably due to a lower perfusion which is correlated with LDF measurements and flap complications. LDF measurements prior to division of the pedicle revealed higher blood flow in zone I compared to zone IV (P<0.000). Our study revealed different microcirculatory blood flow patterns in the first postoperative days when comparing zone I to zone IV. Near ischemia LDF values were measured in zone IV during the first 48 h. Only during the second and third day of the study these values increased steeply to near zone I blood flow values (Figure 4.3). In some patients LDF values in zone IV even surpassed those measured in zone I in the latter part of the study (data not shown). LDF measurements prior to division of the pedicle showed a lower blood flow in both measurement sites when comparing patients with FC to patients without FC, however, this was not statistically significant (Figure 4.4 and Figure 4.5). During the initial 5 hours after reperfusion the mean LDF measurements in the flaps with FC demonstrated a lower increase of blood flow in zone IV (Figure 4.5). 62
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