Microdialysis is admitted to be reliable by numerous surgeons to monitor flaps. Nevertheless, a few authors reported follow up with microdialysis in bone free flaps, and they all describe the position of the catheter in the surrounding soft tissue muscle which is not the accurate reflect of bone vascularisation. The aim of this study is to determine the lactate/pyruvate ratio mean value in bone free flaps with a microdialysis catheter directly positioned in the bone tissue.
Failure rate of facial reconstructive surgery with bone free flaps varies between 11 and 25%. In case of buried bone free flaps, the follow up is even more difficult. Monitoring methods, such as the implantable Doppler system, laser Doppler flowmetry and microdialysis have been developped in the last 15 years. Ferguson et al. show a false positive rate of 31% with implantable doppler monitoring of buried flaps. The purpose of this study is to to determine the lactate/pyruvate ratio mean value in bone free flaps with a microdialysis catheter directly positioned in the bone tissue.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
40
Glucose values will be recorded during 5 days as following : every hour at day 0, every 2 hours at day 1, every 3 hours at days 2 to 5.
Lactate values will be recorded during 5 days as following : every hour at day 0, every 2 hours at day 1, every 3 hours at days 2 to 5.
pyruvate values will be recorded during 5 days as following : every hour at day 0, every 2 hours at day 1, every 3 hours at days 2 to 5.
CHU Amiens
Amiens, France
RECRUITINGChange from Baseline of lactate/pyruvate ratio in patients without free flap ischemia
Change from Baseline of lactate/pyruvate ratio in patients without free flap ischemia
Time frame: every hour during the day of surgery
Change from Baseline of lactate/pyruvate ratio in patients without free flap ischemia
Change from Baseline of lactate/pyruvate ratio in patients without free flap ischemia
Time frame: every 2 hours at day 1 after surgery
Change from Baseline of lactate/pyruvate ratio in patients without free flap ischemia
Change from Baseline of lactate/pyruvate ratio in patients without free flap ischemia
Time frame: every 3 hours at days 2, 3 , 4 and 5 after surgery
Change from Baseline of lactate/pyruvate ratio in patients without fibula free flap ischemia
Change from Baseline of lactate/pyruvate ratio in patients without fibula free flap ischemia
Time frame: every hour during the day of surgery
Change from Baseline of lactate/pyruvate ratio in patients without fibula free flap ischemia
Change from Baseline of lactate/pyruvate ratio in patients without fibula free flap ischemia
Time frame: every 2 hours at day 1 after surgery
Change from Baseline of lactate/pyruvate ratio in patients without fibula free flap ischemia
Change from Baseline of lactate/pyruvate ratio in patients without fibula free flap ischemia
Time frame: every 3 hours at days 2, 3 , 4 and 5 after surgery
Change from Baseline of lactate/pyruvate ratio in patients without crest free flap ischemia
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glycerol values will be recorded during 5 days as following : every hour at day 0, every 2 hours at day 1, every 3 hours at days 2 to 5.
Bone free flaps will be monitored with a microdialysis catheter directly positioned in bone tissue.
Change from Baseline of lactate/pyruvate ratio in patients without crest free flap ischemia
Time frame: every hour during the day of surgery
Change from Baseline of lactate/pyruvate ratio in patients without crest free flap ischemia
Change from Baseline of lactate/pyruvate ratio in patients without crest free flap ischemia
Time frame: every 2 hours at day 1 after surgery
Change from Baseline of lactate/pyruvate ratio in patients without crest free flap ischemia
Change from Baseline of lactate/pyruvate ratio in patients without crest free flap ischemia
Time frame: every 3 hours at days 2, 3 , 4 and 5 after surgery
Change from Baseline of lactate/pyruvate ratio in patients with free flap ischemia
Change from Baseline of lactate/pyruvate ratio in patients with free flap ischemia
Time frame: every hour during the day of surgery
Change from Baseline of lactate/pyruvate ratio in patients with free flap ischemia
Change from Baseline of lactate/pyruvate ratio in patients with crest free flap ischemia
Time frame: every 2 hours at day 1 after surgery
Change from Baseline of lactate/pyruvate ratio in patients with free flap ischemia
Change from Baseline of lactate/pyruvate ratio in patients with crest free flap ischemia
Time frame: every 3 hours at days 2, 3 , 4 and 5 after surgery
Change from Baseline of metabolites rate in patients with free flap ischemia
Metabolites measurement are glucose, lactate , pyruvate and glycerol rates.
Time frame: every hour during the day of surgery
Change from Baseline of metabolites rate in patients with free flap ischemia
Metabolites measurement are glucose, lactate , pyruvate and glycerol rates.
Time frame: every 2 hours at day 1 after surgery
Change from Baseline of metabolites rate in patients with free flap ischemia
Metabolites measurement are glucose, lactate , pyruvate and glycerol rates.
Time frame: every 3 hours at days 2, 3 , 4 and 5 after surgery