gms | German Medical Science

Objectives/Interrogation: In the field of hand surgery, the 'wide-awake' anaesthetic technique using one-permil-tumescent has been shown to allow the possibility of safely and successfully performing on unimpaired vascularity tissues. This study is aimed to establish fact that the methods could also be used safely on viable skin flaps, in which the tissues once suffered from an ischemic condition.

Methods: 40 groin flaps from 20 healthy Wistar strained-Rattus novergicus weighing 220-270 grams were conditioned to acute ischemia by clamping the pedicle for 15 minutes. Merely totally survived and viable flaps on the seventh postoperative day were randomly divided into: One-per-mil tumescent infiltration group (A), normal saline infiltration group (B), and control group (C). Before and after the infiltration, transcutaneous oxygen tension (TcPO2) measurement was performed, and the changes values were calculated by statistical analysis using ANOVA and Paired T-Test. Viability of flaps was assessed clinically and by using Analyzing Digital Images® 7 days later.

Results and Conclusions: TcPO2 readings yielded a decreasing value significantly (p<0.001) following both One-per-mil tumescent and normal saline infiltration. All groin flaps had successfully survived with no signs of tissue necrosis.

The effect of One-per-mil tumescent injection on viable skin flaps was found safe. This result may bring out a consideration of using one-per-mil tumescent injection as local anaesthesia for assisting the future secondary reconstructive procedures such as flap revision or furthermore, reconstructive procedures after finger replantation.