Background: 

The glabellar flap is a common technique for surgical repair after tumor excision in the medial canthal area. However, the outcome may be affected by partial flap necrosis. Little is known about the impact of surgery on blood perfusion and the postoperative course of reperfusion due to the absence of reliable and noninvasive perfusion monitoring techniques. The aim of this study was to use a modern imaging technique to assess blood perfusion in glabellar flaps.

Methods: 

Glabellar flaps were used to repair medial canthal defects following tumor excision in 7 patients. Blood perfusion was monitored using laser speckle contrast imaging: during surgery, immediately postoperatively (0 weeks), and at follow-up, 1, 3, and 6 weeks after surgery.

Results: 

Perfusion decreased gradually along the length of the flap, and reached a minimum 15 mm from the flap base. Perfusion in the proximal 20 mm of the flap was completely restored after 1 week, while the distal part of the flap was gradually reperfused over 6 weeks. Both the functional and esthetic surgical outcomes were excellent.

Conclusions: 

The rapid reperfusion of the glabellar flap may be explained by its connection to the vascular network via the flap pedicle. In flaps longer than 20 mm, the distal part can be considered a free skin transplant, and a combination of a glabellar flap and a free skin graft could then be considered.

中文翻译：

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用于修复内眦缺损的眉间皮瓣血液灌注的激光散斑对比成像

背景： 

眉间皮瓣是内眦区域肿瘤切除后外科修复的常用技术。然而，结果可能会受到部分皮瓣坏死的影响。由于缺乏可靠的无创灌注监测技术，人们对手术对血液灌注的影响和术后再灌注过程知之甚少。本研究的目的是使用现代成像技术来评估眉间皮瓣的血液灌注。

方法： 

7 例患者采用眉间皮瓣修复肿瘤切除后的内眦缺损。使用激光散斑对比成像监测血液灌注：手术期间、术后立即（0周）以及随访时、手术后1、3和6周。

结果： 

灌注沿着皮瓣长度逐渐减少，并在距皮瓣基部 15 mm 处达到最低值。1周后，皮瓣近端20mm的灌注完全恢复，而皮瓣远端部分在6周内逐渐再灌注。功能性和美学性手术结果均非常理想。

结论： 

眉间皮瓣的快速再灌注可以通过其通过皮瓣蒂与血管网络的连接来解释。对于长度超过20毫米的皮瓣，远端部分可以考虑游离皮移植，然后可以考虑眉间皮瓣和游离皮移植的组合。