| First aid for failing flaps. | |
| | |
MedLine Citation:
|
PMID: 20571981 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
Wound coverage with pedicled (local, regional, or distant) or free flaps is commonplace throughout plastic surgery. However, irrespective of the method of tissue transfer or type of tissue being transferred, inflow and outflow remain key parameters for success. Much has been written detailing complex tissue transfers and delineating arterial and venous anatomy. Despite this, simple venous insufficiency causing venous congestion is common. In experimental models, when arterial inflow is impaired, even mild venous inadequacy affects flap survival. Furthermore, studies have shown that venous congestion is more detrimental to the rate and percentage of flap area surviving than arterial ischemia. Obviously, complete venous occlusion typically requires operative exploration and correction, but many instances occur when venous congestion occurs for reasons other than complete venous thrombosis. Here we detail the basic postoperative "first aid" techniques available to optimize venous drainage. Although these techniques are not a substitute for sound anatomic flap selection, good surgical technique, or re-operation when a significant underlying problem exists, they do offer additional options to improve flap outcomes. |
| | |
Authors:
|
Simon G Talbot; Julian J Pribaz |
Publication Detail:
|
Type: Journal Article; Review Date: 2010-06-22 |
Journal Detail:
|
Title: Journal of reconstructive microsurgery Volume: 26 ISSN: 1098-8947 ISO Abbreviation: J Reconstr Microsurg Publication Date: 2010 Oct |
Date Detail:
|
Created Date: 2010-09-15 Completed Date: 2011-01-13 Revised Date: 2011-02-16 |
Medline Journal Info:
|
Nlm Unique ID: 8502670 Medline TA: J Reconstr Microsurg Country: United States |
Other Details:
|
Languages: eng Pagination: 513-5 Citation Subset: IM |
Copyright Information:
|
© Thieme Medical Publishers. |
Affiliation:
|
Division of Plastic Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Female First Aid / methods* Follow-Up Studies Free Tissue Flaps / blood supply Graft Rejection / prevention & control* Heparin / therapeutic use Humans Hyperemia / etiology, therapy* Leeching Male Microsurgery / adverse effects, methods* Postoperative Care / methods Postoperative Complications / diagnosis, therapy Reconstructive Surgical Procedures / adverse effects*, methods Reoperation / methods Surgical Flaps / adverse effects, blood supply* Tissue and Organ Harvesting Treatment Outcome |
| Chemical | |
Reg. No./Substance:
|
9005-49-6/Heparin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: [Foreign Dentures and Dental Tourism - Willingness-to-Pay and Factors Influencing the Demand for For...
Next Document: The proximally designed sural flap based on the accompanying artery of the lesser saphenous vein.