A survey of microvascular protocols for lower extremity free tissue transfer II: postoperative care

Annals of Plastic Surgery
George XipoleasPeter J Taub

Abstract

Due to the complex, and often tenuous nature of microsurgical tissue transfer, postoperative monitoring of free tissue flaps plays a vital role in the management of such patients. Some of the more challenging reconstructive problems occur in patients with lower extremity trauma, yet to date, no preferred protocol exists for the postoperative care of lower extremity free flaps. The present study sought to evaluate and assess current preferences in monitoring following lower extremity free tissue transfer. Members of the American Society of Plastic Surgeons (ASPS) were surveyed with regard to their choice for postoperative monitoring and return to dependent positioning ("dangling"). The results demonstrate that there is some agreement among surgeons regarding the optimal means for postoperative monitoring. Most rely on clinical observation in addition to conventional Doppler probe for an average of 4.8 days. Most surgeons follow their own flaps in addition to relying on the residents and nursing staff. The study also notes a wide variety in the times and frequencies at which dangling of the extremity was commenced. Most respondents initiate dangling within 2 weeks of surgery and begin with only 1 to 5 minutes per session.

References

Jan 1, 1991·Annales de chirurgie de la main et du membre supérieur : organe officiel des sociétés de chirurgie de la main = Annals of hand and upper limb surgery·H J BunckeB S Alpert
Aug 1, 1991·British Journal of Plastic Surgery·F CanalesH J Buncke
Feb 1, 1988·Annals of Plastic Surgery·R CasanovaL O Vasconez
Jul 1, 1987·Annals of Plastic Surgery·T KaufmanM Klain

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Citations

Mar 27, 2012·Operative Orthopädie und Traumatologie·K KnoblochP M Vogt
Dec 1, 2017·Plastic and Reconstructive Surgery. Global Open·Rahul VemulaOren Tessler
Oct 8, 2014·Plastic and Reconstructive Surgery. Global Open·Shimpei MiyamotoMinoru Sakuraba
Feb 6, 2018·Annals of Plastic Surgery·Michael J OrseckManuel Trujillo
Feb 27, 2015·Plastic and Reconstructive Surgery·Kenneth L FanKaren K Evans
Jan 3, 2013·Microsurgery·Paige M FoxGordon K Lee
Aug 6, 2020·Annales de chirurgie plastique et esthétique·P TaW Hu
May 15, 2021·The Journal of Surgical Research·Z-Hye LeeJamie P Levine
Apr 10, 2021·Diseases of the Colon and Rectum·Shlomo YellinekSteven D Wexner
Apr 10, 2017·Journal of Stomatology, Oral and Maxillofacial Surgery·N SigauxP Breton

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