Contents Chapter 1 Introduction and objectives 9 Chapter 2 Peri‐operative fluid overload increases anastomosis thrombosis 25 in the free TRAM flap used for breast reconstruction Chapter 3 Ischemia‐reperfusion injury: A summary of events and the 37 role of nitric oxide in free tissue transfers Chapter 4 A study of perfusion of the distal free‐TRAM flap using 55 laser Doppler flowmetry Chapter 5 Risk factors and blood flow in the free transverse rectus 69 abdominis (TRAM) flap: Smoking and high flap weight impair the fFree TRAM flap microcirculation Chapter 6 Arginine improves microcirculation in free transverse rectus 85 abdominus myocutaneous flap after breast reconstruction: A randomized, double‐blinded clinical trial Chapter 7 Partial flap loss in the DIEP‐flap model: a resultant of arterial/ 99 venous flap anatomy and ischemia‐reperfusion injury (Introducing the zone of injury concept) Chapter 8 Summary, Discussion and future perspectives 111 Acknowledgements (Dankwoord) 123 Curriculum vitae 129 List of publications 133
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