Flap salvage in a "flow-through" flap by manual thrombectomy plus thrombolytic therapy

Journal of Reconstructive Microsurgery
G WechselbergerM Ninković

Abstract

A delay in identifying incipient flap failure may inevitably lead to complete pedicle thrombosis and the no-reflow phenomenon. The authors report a clinical case of a lateral arm free flap that suffered complete pedicle thrombosis. They successfully salvaged this flap, a type C fasciocutaneous "flow-through" flap, by manually moving the thrombus from proximal to distal in the main flap artery. This freed the septofasciocutaneous upward-perforating branches, by smoothing and applying firm pressure to the vessel, combined with thrombolytic therapy. Their technique is offered as an alternative procedure for salvaging a failing flow-through flap.

Citations

Aug 21, 2007·Microsurgery·Sandeep S Vijan, V Nho Tran
Sep 6, 2005·Microsurgery·Salvatore D'ArpaFrancesco Moschella
Mar 10, 2006·Plastic and Reconstructive Surgery·Alizan A KhalilJohn C Hall
Jun 19, 2001·Annals of Plastic Surgery·N W YiiG L Robb
Jul 27, 2002·Plastic and Reconstructive Surgery·Abdulkadir BacakogluAhmet Ekin

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