Thermoregulatory response of anterolateral thigh flap compared with latissimus dorsi myocutaneous flap: An evaluation of flaps cutaneous flow and velocity due to thermal stress

Abstract

Although, the success of free flaps has increased in the last years, more details about its characteristics might improve the clinical outcome of the flaps. This study examined the thermoregulatory ability as a sign of neural re-innervation of two different types of microsurgical free flaps in the postoperative course. A total of 22 patients were examined after grafting two different flap types: The latissimus dorsi myocutaneous (LDM) flap (n = 11) and the anterolateral thigh (ALT) flap (n = 11). Patients were examined 6 and 9 months postoperatively. After exposure to cold and warm water (10°C and 35°C), multiple measurements were performed with the focus on blood velocity and flow using the "O2C" device. Both examined flaps showed a tendency for improvement in local blood flow and velocity due to thermal stress. We recorded a more physiological thermoregulation during thermal stress for the LDM flap, when compared with the ALT flap over a measured period of time. We believe that the presence of the muscle portion in the LDM flap may offer better conditions for thermoregulation based on the improvement of neural and vascular regeneration. However, further studies should clarify the pathophysiological backgrounds, to make these interesting results clinically applicable.