Muscle fiber diameter and muscle type distribution following free microvascular muscle transfers: A prospective study

The histology of free microvascular muscle flaps in 19 patients was studied prospectively. Biopsies were taken during operation, and after 2 and 6 weeks, as well as 3, 6, and 9 months, postoperatively, fixed and stained using the van Gieson method. Fiber diameters were analyzed morphometrically and...

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Bibliographic Details
Published in:	Microsurgery Vol. 18; no. 2; pp. 137 - 144
Main Authors:	Kauhanen, M. Susanna C., Salmi, Asko M., Von Boguslawsky, E. Kristina, Leivo, Ilmo V.V., Asko-Seljavaara, Sirpa L.
Format:	Journal Article
Language:	English
Published:	New York Wiley Subscription Services, Inc., A Wiley Company 1998 Wiley-Liss
Subjects:	Adolescent Adult Aged Atrophy Biological and medical sciences Biopsy, Needle Culture Techniques Female Fibrosis Follow-Up Studies Graft Rejection Graft Survival Humans Immunohistochemistry Male Medical sciences Microsurgery - methods Middle Aged Muscle Fibers, Skeletal - pathology Muscle, Skeletal - pathology Muscle, Skeletal - transplantation Muscular Atrophy - pathology Orthopedic surgery Prospective Studies Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgical Flaps - pathology Vascular Surgical Procedures - methods Human Immunohistochemistry Postoperative Pathophysiology Lower limb Plastic surgery Histology Muscular fiber Striated muscle Atrophy Pathology Orthopedic surgery Biopsy Surgery Free flap Myosin Microsurgery Transfer Evolution Morphometry Diameter Denervation
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Summary:	The histology of free microvascular muscle flaps in 19 patients was studied prospectively. Biopsies were taken during operation, and after 2 and 6 weeks, as well as 3, 6, and 9 months, postoperatively, fixed and stained using the van Gieson method. Fiber diameters were analyzed morphometrically and fiber types defined immunohistochemically using myosin fast antibody. During the nine‐month follow‐up period, mean muscle fiber diameter decreased significantly (P< 0.01), type‐1 fibers atrophied significantly (P< 0.05) compared to type‐2 fibers, and the percentage of type‐2 fibers increased from a mean of 56% intraoperatively to 73% at 9 months. Fatty change and fibrosis were already present 2 weeks after operation and increased with the duration of follow‐up. The decrease in muscle fiber diameter 9 months after free flap transfer correlated with clinical factors such as the delay of reconstructive surgery, recipient site, postoperative infection, and postoperative immobilization. The present results confirm that type‐specific atrophy related to denervation appears and indicates that clinical events other than denervation influence the muscle atrophy seen in human free muscle flaps. These findings focus attention on the role of muscle regeneration, reinnervation, and revascularization taking place after free flap transfer. © 1998 Wiley‐Liss, Inc.MICROSURGERY 18:137‐144 1998
Bibliography:	istex:2CB64BACFECA7A6FE8E97AC70B4FE13AC15E0B4C Finska Läkaresällskapet, Helsinki ArticleID:MICR13 ark:/67375/WNG-HVTDTDQ8-C ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23
ISSN:	0738-1085 1098-2752
DOI:	10.1002/(SICI)1098-2752(1998)18:2<137::AID-MICR13>3.0.CO;2-Z