Perfusion disorders in abdominoplasty: anatomical basis and clinical implications

Objective. To analyze modern data on perfusion disorders in abdominoplasty taking into account anatomical features of blood supply to anterior abdominal wall, risk factors of ischemic complications, and objective assessment of tissue perfusion. Material and methods. Analytical review of national and foreign literature was devoted to vascular anatomy of anterior abdominal wall, features of microcirculation in abdominoplasty, influence of surgical technique on tissue perfusion and modern methods of objective monitoring. Results. Viability of adipocutaneous flap in abdominoplasty is determined by combination of factors, including anatomical organization of vascular network, microcirculation, extent of surgical dissection, and tissue tension distribution. Impaired perfusion is regarded as one of the key mechanisms underlying ischemic complications, such as necrosis of adipocutaneous flap, impaired wound healing and seroma. Modern methods for visualization of microcirculation, including indocyanine green fluorescence angiography, infrared thermography, and near-infrared spectroscopy, enable more accurate assessment of tissue viability and detection of local hypoperfusion. Conclusion. Understanding the anatomical and physiological features of blood supply to anterior abdominal wall and mechanisms of microcirculation impairment is essential for prevention of ischemic complications in abdominoplasty. Modern surgical techniques and objective perfusion monitoring can contribute to higher safety of procedure and better clinical outcomes.