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Primary thrombolysis for free flap surgery in head and neck reconstruction: a case report and review
- Source :
- Archives of Plastic Surgery, Vol 48, Iss 5, Pp 511-517 (2021), Archives of Plastic Surgery
- Publication Year :
- 2021
- Publisher :
- Korean Society of Plastic and Reconstructive Surgeons, 2021.
-
Abstract
- The use of free flaps is an essential and reliable method of reconstruction in complex head and neck defects. Flap failure remains the most feared complication, the most common cause being pedicle thrombosis. Among other measures, thrombolysis is useful when manual thrombectomy has failed to restore flap perfusion, in the setting of late or established thrombosis, or in arterial thrombosis with distal clot propagation. We report a case of pedicle arterial thrombosis with distal clot propagation which occurred during reconstruction of a maxillectomy defect, and was successfully treated with thrombolysis using recombinant tissue plasminogen activator. We also review the literature regarding the use of thrombolysis in free flap surgery, and propose an algorithm for the salvage of free flaps in head and neck reconstruction.
- Subjects :
- medicine.medical_specialty
RD1-811
business.industry
medicine.medical_treatment
Pediatric/Craniomaxillofacial/Head&Neck
Flap failure
Case Report
Thrombolysis
medicine.disease
Thrombosis
Surgery
reconstructive surgical procedures
fibrinolytic agents
medicine
free tissue flaps
Recombinant tissue plasminogen activator
Complication
Head and neck
Free flap surgery
business
Fibrinolytic agent
thrombolytic therapy
surgery, plastic
Subjects
Details
- Language :
- English
- ISSN :
- 22346171 and 22346163
- Volume :
- 48
- Issue :
- 5
- Database :
- OpenAIRE
- Journal :
- Archives of Plastic Surgery
- Accession number :
- edsair.doi.dedup.....0364789c6b924f2ec996427965834b64