Pathophysiology in horses involves the study of functional changes that occur in the body as a result of disease or injury. This field examines the mechanisms through which diseases develop and progress, as well as how they affect the body's normal physiological processes. In equine research, pathophysiology encompasses a wide range of conditions, including respiratory disorders, musculoskeletal injuries, gastrointestinal diseases, and metabolic syndromes. Understanding these processes helps in identifying potential therapeutic targets and developing effective treatment strategies. This page collects peer-reviewed research studies and scholarly articles that explore the underlying mechanisms, clinical manifestations, and implications of various pathophysiological conditions in equine health.
Orr JA, Bisgard GE, Forster HV, Buss DD, Dempsey JA, Will JA.Unanesthetized adult female ponies were studied near sea level (250 m) and during sojourns to 3400 m (N=6) and 4300 m (N=7) altitude. The pH, PCO2, and PO2 of arterial blood and pH and PCO2 of cerebrospinal fluid (CSF) were measured under conditions of acute (1 hr) and chronic (1-45 days) hypoxia. Cerebrospinal fluid was sampled from the cisterna magna of the awake pony and arterial blood withdrawn from an indwelling arterial catheter. In both groups of animals, PaCO2 decreased slightly after 1 hr of hypoxia (delta PaCO2= - 0.6 mm Hg at 3400 m; - 3.9 mm Hg at 4300 m), decreased further after 1...
Beadle RE, Robinson NE, Sorenson PR.The cardiopulmonary effects of 0, 5, 10, and 15 cm of H2O positive end-expiratory pressures (PEEP) were determined in anesthetized, spontaneously breathing horses, using a 4 by 4 Latin-square design with one repetition. Cardiac output, alveolar-arterial oxygen tension difference, alveolar ventilation, dead space/tidal volume ratio, and carbon dioxide elimination were not significantly altered by the procedure. As PEEP was increased, alveolar and arterial oxygen tensions, respiratory exchange ratio, and pH decreased, whereas arterial carbon dioxide tension and oxygen consumption increased. Thes...
Schmoldt A, Benthe HF, Haberland G, Tarentino AL, Maley F, Berkmen YM, Lande A, Ti-sheng C, Teh-chao W.The chest roentgenographic findings in Takayasu's arteritis include widening of the ascending aorta, contour irregularities of the descending aorta, arotic calcifications, pulmonary arterial changes, rib notching, and hilar lymphadenopathy. The single most important diagnostic sign is a segmental calcification outlining a localized or diffuse narrowing of the aorta. The other signs may be suspicious or suggestive, but the diagnostic accuracy increases when several findings are present simultaneously.
Hall LW, Trim CM.Horses breathing spontaneously under halothane anaesthesia were subjected to expiratory resistance by the introduction of a water-trap into the expiratory limb of a circle absorber. Resistances of 10 and 20 cm H2O produced no significant increase in PaO2 (P greater than 0.05) during halothane/air and halothane/oxygen anaesthesia. The imposition of resistance was associated with an increase in PaCO2 and a significant increase in mixed venous PCO2. In three animals subjected to 20 cm H2O resistance under halothane/air anaesthesia, the cardiac output was reduced (P less than 0.01). It was conclud...
Glazier DB, Farrelly BT, O'Connor J.A congenital heart defect characterised by persistent patency (open-ness) of the ventricular septum, permitting flow of blood directly between ventricles, bypassing the pulmonary circulation and resulting in various degrees of cyanosis (blue discolouration of the skin) due to oxygen deficiency. Clinical signs include systolic murmur and a palpable thrill on both sides of the chest, dyspnoea and poor tolerance of exercise.
Roberts MC, Pinsent PJ.Three horses suffering from malabsorption were shown to have alimentary lymphosarcoma predominantly affecting the small intestine and the associated lymph nodes. The diffuse cellular infiltration in two of the case produced marked changes in the villous architecture reducing the available mucosal surface area, and, with lowered or barely detectable disaccharidase activities, contributed to the impairment of digestive-absorptive processes. One of the horses maintained a voracious appetite and was not diarrhoeic, but failed to gain weight, indicating differences in the production and utilisation...
Baker JR, Leyland A.In a histological survey of 244 tumerous growths from 155 horses, the tumours commonly found were fibromas, squamous cell carcinomas, sarcoids and papillomas, most frequently affecting the skin, external genitalia, eye and orbit. The histological features that differentiate fibroblastic citaneous growths are detailed so that the clinical behaviour of these distinct neoplasms can be studied.
Muir WW, Moore CA, Hamlin RL.The influence of various concentrations of CO2 and O2 in the inspired gases on minute volume (V), tidal volume (VT), and respiratory rate (breaths per min; BPM) was examined in nonanesthetized, nonsedated normal horses. The VT and BPM increased linearly in response to increases in inspired CO2 concentration and curvilinearly in response to decreases in inspired Os concentration. The V increased curvilinearly in response to both increases in inspired CO2 concentration and decreases in inspired O2 concentration.
Wensing T, van Gent DM, Schotman AJ, Kroneman J.(I) The lipid and lipoprotein concentrations in sera of 4 healthy and 9 hyperlipaemic patients were determined. From the results of the analyses, it is suggested that three types of hyperlipoproteinaemia can be distinguished in ponies: (a) Type 1, characterised by a very pronounced increase in only the very low density lipoproteins (VLDL); (b) Type 2, in which there is a pronounced increase in the chylomicrons (Chylo) and the very low density lipoproteins (VLDL); (c) Type 3, which can be the result of fasting and is characterised by a moderate increase in the concentration of chylomicrons and ...
Bisgard GE, Orr JA, Will JA.Hemodynamic measurements were made in 6 ponies at low altitude (Madison, WI, altitude, 250 m) and after 1, 2, 4, and 6 weeks at high altitude (Climax, CO, altitude, 3,400 m). The salient findings were that ponies maintain an increased heart rate and cardiac output and develop significant pulmonary hypertension at high altitude. The average control resting mean pulmonary artery pressure (BPpul) was 25.1 mm of Hg at 250 m; this value increased to 56.3 mm of Hg after 6 weeks at 3,400 m. An additional finding was that the pulmonary vascular response to acute hypoxia seemed to increase with time at...
Krook L, Whalen JP, Lesser GV, Berens DL.Nutritional secondary hyperparathyroidism (NSH) defines a spontaneous and experimental disease in most domesticated and in some wild animals, caused by dietary calcium deficiency and/or phosphorus excess. Calcium deficiency results directly in hypocalcemia, and phosphorus excess induces hyperphosphatemia which causes hypocalcemia. Secondary hyperparathyroidism thus results and the plasma parameters return to normal and are maintained but only at the expense of progressive bone loss. The bone loss is generalized but the bones are not uniformly affected. The hierarchy of bone loss is, in decreas...
Ackerman N, Garner HE, Coffman JR, Clement JW.The angiographic appearance of the normal equine foot was compared with the appearance of equine feet affected with chronic laminitis. The normal foot was characterized by complete filling of the terminal arch, 8 to 10 main branches between 0.1 and 0.2 cm in diameter, a symmetrical netlike vascular pattern in the corium of the hoof, and numerous fine vessels in the corium of the coronary band. The feet affected with chronic laminitis were characterized by poor filling of the terminal arch, larger and less numerous primary branches, an irregular vascular pattern in the corium of the hoof, areas...
Williams MR.Rats were injected intradermally with rabbit anti-ovalbumin serum and 3 hours later were challenged intravenously with ovalbumin and Evans Blue dye. Inflammatory lesions were produced within 20 minutes and their size was markedly dose-dependent. Attempts were made to interfere with this passive cutaneous anaphylaxis (PCA) by admixture of normal IgG with the rabbit anti-ovalbumin to measure the relative tissue binding affinities of IgG from various species. It was found that normal IgG from any of the species tested had an enhancing effect on PCA in rats. These immunoglobulins serially arranged...
Knecht S, Luechinger R, Boesiger P, Stüssi E.The mechanical property of articular cartilage determines to a great extent the functionality of diarthrodial joints. Consequently, the early detection of mechanical and, thus, functional changes of cartilage is crucial for preventive measures to maintain the mobility and the quality of life of individuals. An alternative to conventional mechanical testing is the inverse finite element approach, enabling non-destructive testing of the tissue. We evaluated a method for the assessment of the equilibrium material properties of the patellar cartilage based on magnetic resonance imaging during pate...
Harmegnies NF, Duvivier DH, Vandenput SN, Art T, Lekeux PM, Votion DM.This study aimed to compare exercise-induced pulmonary perfusion redistribution in healthy vs. 'heavey' horses using scintigraphy, a minimally invasive technique. Six healthy (A) and 5 'heavey' horses in remission (B(I)) and during clinical signs of disease (B(II)) were investigated. Dimensions of the exercising pulmonary perfusion (QE) images were expressed in percent of the resting perfusion (QR) images. Computed QE to QR ratios (QE/QR) images enabled the definition of the region more perfused at exercise than at rest (R1). In all groups, exercise induced a major enlargement of the Q image b...
Wright JA, Fordyce P, Edington N.Ultrastructural lesions of the cranial nerves and their ganglia and the autonomic nervous system from 5 cases of neuritis of the cauda equina in the horse are described. They include lysosomal inclusions within the semilunar, geniculate and sympathetic chain ganglia, granulomatous involvement of the coeliaco-mesenteric ganglion and accumulation of axonal organelles in unmyelinated fibres of the great splanchnic nerve, sympathetic chain and oesophageal vagus.
Geisel O, von Sandersleben J.The chronic obstructive pulmonary disease (COPD) in horses is primarily based on a chronic bronchitis/bronchiolitis with constriction of the tubes in the lower respiratory tract. The outward appearance of the lung is characterized by a diffuse or marginal alveolar emphysema. The big bronchial tubes are usually not altered. Small bronchi and bronchioli can often be seen through the pulmonal pleura. On the sectional area they are visible as opaque grey-red nodules with a central lumen detectable under a magnifying glass. The histopathological picture of alterations in the bronchial tree can vary...
Koterba AM, Kosch PC.Breathing pattern, respiratory muscle activation pattern, lung volumes and volume-pressure characteristics of the respiratory system of normal, term, neonatal foals on Days 2 and 7 of age were determined to test the hypothesis that the foal actively maintains end-expiratory lung volume (EEV) greater than the relaxation volume of the respiratory system (Vrx) because of a highly compliant chest wall. Breathing pattern was measured in the awake, unsedated foal during quiet breathing in lateral and standing positions. The typical neonatal foal breathing pattern was characterized by a monophasic in...
Tesfaigzi Y.Exposure of airways to environmental toxins or allergens induces proliferation of epithelial cells. Depending on the type of exposure, existing and newly formed cells can differentiate into mucus-producing cells resulting in mucous cell metaplasia (MCM). During recovery, the epithelium reduces the number of epithelial cells to return to the original state. Understanding the mechanisms involved in this resolution could be useful in deleting mucous cells and, thereby, mucous secretions. We have found that metaplastic mucous cells induced by exposure to ozone, endotoxin, cigarette smoke or allerg...
Otto S, Michler JK, Dhein S, Mülling CKW.Distal axonopathy is seen in a broad range of species including equine patients. In horses, this degenerative disorder of the recurrent laryngeal nerve is described as recurrent laryngeal neuropathy (RLN). The dysfunctional innervation of the cricoarytenoideus dorsalis muscle (CAD) leads to a loss of performance in affected horses. In general, ex vivo models of the larynx are rare and for equine patients, just one short report is available. To allow for testing new therapy approaches in an isolated organ model, we examined equine larynges in a constant pressure perfused setup. In order to chec...
Olver CS, Nielsen VG.Carboxyheme and metheme states modulate hemostasis in humans and other species. Further, carbon monoxide and/or nitric oxide production increase in inflammatory disorders involving the gastrointestinal tract, with associated hypercoagulability or hypocoagulability. In particular, the horse suffers both thrombotic or coagulopathic complications during acute gastrointestinal disease. This investigation characterized the thrombelastographic response to carboxyheme (via CORM-2) or metheme (via phenylhydroxylamine, PHA) states without/with addition of tissue type plasminogen activator. Citrated pla...
Beech J, Fletcher JE, Erwin K, Lindborg SR.To determine sensitivity of equine skeletal muscle to tetrodotoxin and compare that with sensitivity of murine and human skeletal muscles. Methods: Semimembranosus, vastus lateralis, triceps brachii, and masseter muscle specimens from 22 euthanatized horses, vastus lateralis muscle biopsy specimens from 25 clinically normal humans, and diaphragmatic muscle specimens from 6 mice. Methods: Electrically elicited twitch responses were measured in muscle specimens incubated in medium alone and with tetrodotoxin (100 nM, 400 nM, 1.6 microM for equine specimens and 100 nM, 200 nM, 400 nM, 800 nM, 1.6...
Staddon GE, Weaver BM.The regional perfusion to the lungs of 14 ponies was studied using radioactively labelled microspheres injected intravenously. It was found that within half an hour of induction of anaesthesia the perfusion to the dependent lung had decreased significantly from the values in the standing animal. When anaesthesia was maintained for more than two and a half hours, however, the lung perfusions were not significantly different from the standing values when the animals were lying in lateral or supine recumbency.
Harfoush K, Guintard C, Desfontis JC, Thorin C, Douart C, Mallem MY, Betti E.Dysfunction of venous valves can lead to hemodynamic disorders causing venous stasis, which would favour the occurrence of equine laminitis. However, very few studies have investigated venous valves in the horse digit. The purpose of this study was to compare valvular density between thoracic and pelvic limbs and to study the relationship between valvular density of veins and their location, diameter and wall thickness. After dissection, valvular density was calculated based on the number of valves counted in the principal veins of 7 thoracic and 7 pelvic limbs from 7 horses. Our results showe...
Zizzadoro C, Caruso M, Putignano C, Crescenzo G, Ormas P, Belloli C.The effects of endotoxin on β-adrenergic-mediated relaxation were investigated in the equine digital artery (EDA). Possible involvement of cyclooxygenase-2 (COX-2) in endotoxin-induced effects and basal EDA β-adrenoceptor functionality was also evaluated. Endothelium-intact (e(+)) and/or -denuded (e(-)) EDA rings were incubated overnight with lipopolysaccharide (LPS), LPS+NS398 (selective COX-2 inhibitor) or NS398 alone. Vessel rings were then mounted in organ baths and relaxant responses to isoproterenol (ISOP) recorded on U44069-induced pre-contraction. Response to ISOP was further evaluat...
Schumacher J, Hanselka DV.Nasopharyngeal cicatrices were observed endoscopically in 47 horses examined because of abnormal respiratory noises and/or exercise intolerance. A review of these cases revealed a correlation between cicatrization and age, sex, and the presence of other upper airway abnormalities. The age of affected horses ranged from 6 to 21 years, with a mean age of 12.7 +/- 7.8 (+/- 2 SD) years. Females were affected 2.7 times more frequently than males. Abnormalities commonly observed with a nasopharyngeal cicatrix included chondritis of the arytenoid cartilage, epiglottic deformity, and deformity of the ...
Divers TJ, Warner A, Vaala WE, Whitlock RH, Acland HA, Mansmann RA, Palmer JE.Eight foals, 2 to 5 days of age, with similar clinical signs and laboratory and pathologic findings, died from hepatic failure. The predominant clinical signs were depression and icterus. Abnormally high values were found for plasma ammonia content, aromatic-to-branch-chain amino acid ratio, total serum bilirubin content, gamma glutamyl transferase activity, alkaline phosphatase activity, and PCV; partial thromboplastin time and prothrombin time were prolonged. Some foals had high sorbitol dehydrogenase activity. These laboratory findings were suggestive of subacute hepatic disease and failure...
Hallauer C.1. Equine infectious anemia (EIA) is an immunologically-medicated disease. Immune complexes formed in blood and tissues are responsible for most symptoms and lesions (anemia, splenomegaly, lymphadenopathy, glomerulonephritis, etc.). In addition, a state of cellular hypersensitivity of the delayed type is involved in the pathogenesis. 2. Periodical attacks of pyrexia and clinical illness in the presence of immunity are caused by antigenically-modified variants of virus. By means of immunosuppressive treatments similar relapses of fever associated with the appearance of new virus variants can be...
Jose-Cunilleras E, Hinchcliff KW.Pharmacologic treatment of diseases of the urinary tract of horses is limited to administration of antibiotics for treatment of urinary tract infections (UTIs), administration of drugs that alter urine pH, administration of drugs that alter bladder smooth muscle function or urethral sphincter tone, and treatment of acute renal failure. The indications, mechanisms of action, pharmacokinetic characteristics, and adverse effects of these agents in each of these groups are discussed in this article. The use of the agents is discussed within the context of the pathophysiology of the disease being t...
Argüelles D, Casteljins G, Carmona JU, Armengou L, Climent F, Prades M.In man, peritoneal transforming growth factor beta (TGF-beta) is associated with peritoneal diseases and subsequent adhesion formation. No studies on plasma and peritoneal TGF-beta concentrations in horses with colic are available. Objective: 1) To determine both plasma and peritoneal TGF-beta(1) and TGF-beta(3) concentrations in horses with different types of colic (not previously subjected to abdominal surgery); 2) to compare these concentrations according to the type of peritoneal fluid (transudate, modified transudate and exudate); and 3) to compare and correlate plasma and peritoneal conc...
Erickson BK, Forster HV, Lowry TF, Pan LG, Korducki MJ, Forster AL, Forster MA.The objective of the present study was to determine whether lung and diaphragm afferents contribute to the changes in respiratory muscle activity when end-expiratory lung volume (EELV) is changed in ponies. We studied the responses of the diaphragm and the transversus abdominis (TA) muscles to passive increases in EELV in awake intact (I), diaphragm-deafferented (DD), pulmonary vagal- (hilar nerve) denervated (HND), and DD + HND ponies. Negative pressure of -10 or -20 cmH2O applied around the ponies' torsos [positive transrespiratory (TR) pressure] increased (P < 0.05) EELV in all ponies; t...
McGuigan MP, Walsh TC, Pardoe CH, Day PS, Wilson AM.Previous studies have implicated tension in the deep digital flexor tendon (DDFT) in the rotation of the distal phalanx (DP) after the breakdown of the dorsal laminae caused by laminitis. Howeveer, once the DP has rotated, the DDFT should become shorter, reducing the force it exerts on the DP. Objective: To compare DDFT force and ground reaction forces (GRFs) in normal ponies and ponies with rotation of the DP as a sequel to laminitis. Methods: Six normal ponies (Group 1) and 6 sound ponies with 6-13 degrees of rotation of the DP in relation to the dorsal hoof wall (Group 2) were assessed at t...
Offord S, Tulloch LK, Franklin SH, Tremaine WH, Woodford NS, Allen KJ.The laryngeal tie-forward (LTF) procedure has been shown to move the larynx rostrally and dorsally whilst repositioning the basihyoid bone caudally and dorsally. Other studies have shown that the position of the hyoid bones influences the size of the nasopharynx. The effect of the LTF procedure on the size of the nasopharynx is unknown. It was hypothesised that the LTF procedure would result in a decrease in dorsoventral nasopharyngeal diameter. Twenty-five thoroughbred horses which underwent LTF with or without soft palate cautery (LTF±SPC) for treatment of dorsal displacement of the soft pa...
van der Kolk JH, Klein WR, van der Putten SW, Mol JA.A thirteen-year-old Dutch warmblooded mare was referred to the Faculty of Veterinary Medicine because of a sinusitis. She was thin with a potbellied appearance. Her coat was dull with long wavy hair. Unilateral (left) purulent nasal discharge was evident. A cbc revealed leucopenia (3.9 G.L.-1) and plasma biochemical analysis revealed a plasma glucose concentration of 10.1 mmol.L-1. Thermostable alkaline phosphatase (at 65 degrees C during 2 minutes) could not be demonstrated. Basal plasma cortisol concentration was lowered (114 nmol.L-1) and basal plasma ACTH concentration was highly elevated ...
Zerpa H, Bailey SR, Berhane Y, Elliott J.Alpha-adrenoceptors mediate contractile responses in equine digital veins (EDVs) and arteries. Vascular smooth muscle alpha(1)-adrenoceptor subtypes have been implicated in a number of conditions, such as acute equine laminitis, and are therapeutic targets for the treatment of this condition. Digital veins, rather than arteries, were investigated in the present study because they have been specifically implicated in the pathophysiology of acute laminitis. The order of potency of a series of alpha(1)-adrenoceptor-selective agonists and antagonists was determined in isolated rings of EDVs under ...
Richter RA, Freeman DE, Wallig M, Whittem T, Baker GJ.To study the functional and structural responses of the right dorsal colon (RDC) of ponies to phenylbutazone (PBZ) in vitro at a concentration that could be achieved in vivo. Methods: 8 adult ponies. Methods: Short circuit current and conductance were measured in mucosa from the RDC. Tissues incubated with and without HCO3- were exposed to PBZ, bumetanide, or indomethacin. Bidirectional Cl- fluxes were determined. After a baseline flux period, prostaglandin E2 (PGE2) was added to the serosal surfaces and a second flux period followed. Light and transmission electron microscopy were performed. ...
Viscardi V, Jorge ML, Silva KM, Sad EP, Fonseca AB, Alencar NX, Lessa DA.Collection of fluid from the lower respiratory tract (LRT) plays an important role in both the pathophysiological investigation and diagnosis of respiratory tract disease. Enzymes such as ALP are, among others, indicators of cell damage or death, type II pneumocyte proliferation, and neutrophil invasion, and have been useful as biomarkers of respiratory disease in other species. Objective: The purpose of this study was to determine and compare tracheal wash (TW) ALP activity in healthy horses and horses with LRT inflammation (LRTI) determined by TW cytology profile. Methods: Tracheal washes we...
Brosnan RJ, Steffey EP, Esteller-Vico A, Vaughan B, Liu IK.Digital perfusion pressure (DPP) equals mean arterial pressure (MAP) at the hoof coronet minus digital interstitial pressure (DIP) within the hoof. To test whether lamellar blood flow (LBF) changes proportionately to DPP, anesthesia was induced and maintained with isoflurane in six horses to target a MAP of 60 mmHg. Arterial, venous, and hoof interstitial pressures were measured in each pelvic limb. LBF was measured using fluorescent microspheres during dobutamine infusions targeting either 60 (low), 80 (medium), or 100 (high) mmHg MAP. Following euthanasia, hoof lamina was collected for micro...
Moore RM, Bertone AL, Muir WW.To evaluate the effect of high-molecular weight (MW) dextran macromolecules on low-flow ischemia and reperfusion of the large colon in horses. Methods: Horses subjected to low-flow ischemia and reperfusion of the large colon were treated with either 0.9 NaCl (group 1, n = 6) or high-MW dextran (group 2, n = 6) solutions. Methods: 12 adults horses. Methods: Horses were subjected to 3 hours' low-flow ischemia followed by 3 hours' reperfusion. A dose of either 0.9% NaCl or a 6% solution of high-MW (250,000) dextran (10 ml/kg of body weight) was administered i.v., 30 minutes prior to reperfusion. ...
Sugimoto M, Kuwano A, Ikeda S, Kume S, Yoshihara E, Wada S.To examine the distribution of water in hoof wall specimens of horses via nuclear magnetic resonance (NMR) microscopy and determine changes in water distribution during hydration. Methods: 4 hoof wall specimens (2 obtained from the dorsum and 1 each obtained from the lateral quarter and lateral heel regions) of the stratum medium of healthy hooves of 1 horse. Methods: Equine hoof wall specimens were examined via NMR microscopy. Proton density-weighted 3-D images were acquired. Changes during water absorption were assessed on sequential images. Results: The inner zone of the stratum medium had ...
Stewart RH, Griffiths JP.In spinal cord disease of horses, a complete history, neurologic examination, and adjunctive diagnostic procedures are very helpful in establishing a tentative diagnosis; however, a definitive diagnosis may be difficult or impossible to establish antemortem. Medical management should be initiated with full consideration of possible etiologies and knowledge of the effects and consequences of medical therapies. This article discusses the drugs commonly used in the management of spinal cord disease and the rationale for their use.
Malberg JA, Webb BT, Hackett ES.A 14-year-old Trakehner gelding was evaluated for recurrent colic, with episodes occurring over 1 year. Signs were consistent with intermittent ascending colon obstruction and hematochezia. Necropsy examination revealed an ulcerated mass extending into the lumen of the right dorsal ascending colon. Gross and histologic appearance and immunoreactivity to c-kit (CD117), desmin, vimentin, and smooth muscle actin, were consistent with a diagnosis of gastrointestinal stromal tumor. Tumeur ventrale gastro-intestinale du côlon produisant des coliques et de l’hématochézie et des coliques récurre...
Bristol DG.Caudally based axial pattern and random pattern skin flaps, 5 cm x 10 cm, were raised on the abdomens of seven foals. Blood flow was measured 7.5 cm from the flap bases during incremental increases in applied tension. At tensions less than 1400 g, cutaneous blood flow was more than four times higher in axial pattern flaps than in random pattern flaps. Blood flow in axial pattern flaps at tensions up to 1500 g was greater than baseline flow in random pattern flaps. After removal of applied tension, perfusion in axial pattern flaps gradually increased but remained below baseline values. A short ...