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Mathematics taking guesswork out of plastic surgery tissue transfer
Date:7/14/2009

to model that relationship. They have shown that under certain relationships between the size of the tissue flap and the diameter of the perforator vessel, the oxygen level in the flap will remain above 15 percent of the normal level, thus ensuring a successful flap transfer. If this relationship is not satisfied, the most distant tissue from the vessel will start to die something already observed by clinicians.

"This is still just a concept. But this initial system of five differential equations gives us a range between the flap size and the required diameter of the supporting artery that would ensure survival," said Avner Friedman, a senior author of the paper and a Distinguished University Professor at Ohio State.

The research appears this week in the online early edition of the Proceedings of the National Academy of Sciences.

The routine use of a patient's own tissue from the lower abdominal wall to restore deformities on the chest dates to 1982. In the early days of full removal and transfer of tissue, surgeons took muscle along with skin and fat, resulting in loss of strength where the muscle was removed.

"As time has gone on, we have learned that we don't have to take the muscle, but we can take a single blood vessel coming through the muscle and transfer the tissue on that vessel," Miller explained. "What we're finding is that the more we design flaps like this, the less reliable the tissue is becoming. The motivation to try to reduce injury to muscle is leading to an increase in problems with part of the flap failing because it doesn't have enough blood."

Miller asked Friedman, founding director of Ohio State's Mathematical Biosciences Institute, to work on a model that could add more predictability to tissue transfer.

To create the initial model, Friedman and colleagues needed to determine a number of values: the level of oxygen in the tissue, which comes from tiny capillaries spaced just micr
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Contact: Michael Miller
michael.miller@osumc.edu
614-293-8566
Ohio State University
Source:Eurekalert

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