Ischemia-modified albumin and flap viability

Monitoring flap viability in the postoperative period is important for the prediction of partial or total flap failure. Many alternative methods such as laser Doppler flowmetry, photoplethysmography, infrared spectroscopy, fluorescein injection, evaluation of flap color, turgor, temperature and capillary reflow have been used for this purpose. Although these methods are valuable in the determination of flap condition, they are not sufficient prognostic markers for flaps. In this study, we investigated the relationship between serum ischemia-modified albumin (IMA) values and flap viability. In 20 Wistar rats, caudal-based 9 x 3 cm dorsal flaps were prepared. IMA values were measured before the flap elevation as well as 6 h and 1 week after the surgical procedure. Seven days after the operation, the viable flap areas were calculated. The relationship between changes in the IMA level during the study and viable flap area measurements was investigated. There was no statistically significant correlation between serum IMA level alterations during the preoperative to postoperative 6th hour period and necrotic flap area measurements. This lack of correlation was also present between the change in IMA levels during the preoperative to postoperative 7th day period and necrotic flap area measurements. In conclusion, serum IMA levels do not predict rat skin flap viability.