PLASTIC SURGERY II Early molecular markers of venous ischemia in composite microvascular flaps

INTRODUCTION: Partial or complete flap loss by venous ischemia/ congestion occurs in up to 20% of the over 50,000 muscle and fasciocutaneous flap procedures performed annually in the United States. Early detection of venous ischemia permits flap salvage in greater than 50% of cases, yet detection lacks sensitivity despite visual and transcutaneous Doppler assessments. We hypothesize venous ischemia is accompanied by rapid changes in gene expression, and that these genetic markers can lead to definitive diagnosis of venous flap ischemia prior to surgical re-exploration.