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Flap Venous Congestion and Salvage Techniques: A Systematic Literature Review
- Source :
- Plastic and Reconstructive Surgery, Global Open, Vol 9, Iss 1, p e3327 (2021), Plastic and Reconstructive Surgery Global Open
- Publication Year :
- 2021
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2021.
-
Abstract
- Background:. Venous congestion is a frequent problem in flap surgery. Other than surgical revision, there are a multitude of procedures in the literature to tackle this problem, but their effectiveness is not clear. Through a systematic review, we aimed to identify and evaluate the different interventions available for managing flap venous congestion. Methods:. The MEDLINE, PubMed central, Embase, and Cochrane databases were searched. The study selection process was adapted from the PRISMA statement. All English and French original articles describing or comparing a method for managing flap venous congestion were included. For each article, a level of evidence was assigned, as defined by the Oxford Centre for Evidence-based Medicine. Lastly, we specifically analyzed the effectiveness of postoperative non-surgical methods. No formal analysis was performed. Results:. Through literature searches carried out in various databases, we identified 224 articles. Finally, 72 articles were included. The majority of these studies had a low-level evidence. A total of 17 different methods (7 pre- and intraoperative, and 10 postoperative) were found. Concerning non-surgical methods, the most represented were leeches, local subcutaneous injection of heparin with scarification, venocutaneous catheterization, negative pressure therapy, and hyperbaric oxygen therapy. Conclusions:. Risks of venous congestion of flaps must always be present in a surgeon’s mind, at every stage of flap surgery. Apart from studies on the use of leeches, which have a significant follow-up and large enough patient numbers to support their efficacy, the low-level evidence associated with studies of other methods of venous congestion management does not allow us to draw a scientifically valid conclusion about their effectiveness.
- Subjects :
- medicine.medical_specialty
business.industry
General surgery
lcsh:Surgery
Psychological intervention
MEDLINE
Surgical Revision
lcsh:RD1-811
Evidence-based medicine
Reconstructive
030230 surgery
03 medical and health sciences
0302 clinical medicine
Systematic review
Hyperbaric oxygen
Venous congestion
030220 oncology & carcinogenesis
Medicine
Original Article
Surgery
Stage (cooking)
business
Subjects
Details
- ISSN :
- 21697574
- Volume :
- 9
- Database :
- OpenAIRE
- Journal :
- Plastic and Reconstructive Surgery - Global Open
- Accession number :
- edsair.doi.dedup.....5d13ab0248b544614ad4e101a61f0cd0