The dynamics of gases partial pressure and microcirculation in the axial flaps skin after transposition

Abstract

The dynamics of gas partial pressure (Model 840 VFD percutaneous polarograph, USA) and microcirculation (USDG - Minimax-Doppler K, St. Petersburg, photoplethysmography [PPG] - RGPA-6/12 rheograph polyanalazer, Taganrog) in flaps of axial type blood supply for 1,5 months after their transposition has been evaluated in 19 patients. Three types of the dynamics of the partial pressure of gases in the vascularized skin flap have been singled out: type I - normoxia or mild hypoxia, normocapnia from day 1 after surgery; type II - tissue hypoxia combined with hypercapnia with pCO2 up to 70-90 mm Hg in the first 1-2 days, stabilization of normoxia and normocapnia values by Day 5-7; type III - an instable system of tissue gas supply: hypoxia subsequently (for up to 25 days) - pO2 pronounced variations from 0 to 140 mm Hg and pCO2 - from 0 to 70 mm Hg with 1-3-day interval. By USDG and PPG data the signal of capillary blood flow is not registered for marked hypoxia (p02 from 0-2 mm Hg) and hypercapnia (pC02 - 100-115 mm Hg). In case of hypoxia combined with hypercapnia (pC02 - 60-80 mm Hg) the signal of capillary blood flow is registered with non-constant venous component domination.