Please use this identifier to cite or link to this item:
|Title:||Nonlinear finite element simulations to elucidate the determinants of perforator patency in propeller flaps|
Nonlinear finite element
|Source:||Wong, C.-H.,Cui, F.,Tan, B.-K.,Liu, Z.,Lee, H.-P.,Lu, C.,Foo, C.-L.,Song, C. (2007-12). Nonlinear finite element simulations to elucidate the determinants of perforator patency in propeller flaps. Annals of Plastic Surgery 59 (6) : 672-678. ScholarBank@NUS Repository. https://doi.org/10.1097/SAP.0b013e31803df4e9|
|Abstract:||The propeller-type flap design is increasingly used in reconstructive surgery for various regions of the body. To date, determinants of perforator patency when subjected to twisting have not been elucidated. We propose a simulation model to study parameters affecting perforator patency under such conditions. Nonlinear finite element procedure was used to simulate a perforator consisting of an artery and a vein with both ends fixed. A rigid body was attached to the top of the perforator for applying prescribed angular displacement. The effect of the following parameters on the pedicle patency was determined: (1) increasing angle of twist, (2) vessel stiffness, (3) vessel length, (4) diameter, (5) intraluminal pressure, and (6) the presence or absence of blood flow during twisting. Simulation results were reported in effective stress and strain on the twisted pedicle. In the context of perforator patency, effective strain, which is a measure of vessel deformation or collapse, is the more relevant outcome. The vein was more prone to occlusion because of its weaker wall and lower intraluminal pressure. Four factors that affected perforator patency were identified: angle of twist, intraluminal blood pressure, and perforator diameter and length. There was no significant difference whether twisting was performed prior to or after restoration of blood flow (P > 0.05). Therefore, to optimize condition for maintaining perforator patency, the angle of twist should be kept <180 degrees, perioperative blood pressure should be kept stable (avoiding periods of hypotension), and the selected perforator should be approximately 1 mm in diameter and >30 mm in length. We found that the propeller flap is a feasible design. This study defined the determinants of perforator patency and will serve as a useful guide when performing such flaps. © 2007 Lippincott Williams & Wilkins, Inc.|
|Source Title:||Annals of Plastic Surgery|
|Appears in Collections:||Staff Publications|
Show full item record
Files in This Item:
There are no files associated with this item.
checked on Dec 12, 2017
checked on Dec 15, 2017
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.