Free tissue transfer and deep vein thrombosis

Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS
Dylan J MurrayJoan E Lipa

Abstract

Reconstruction of the post-oncologic defect of the lower limb frequently requires free tissue transfer and these often extensive bone and soft tissue resections can occasionally be compounded by the presence of a deep venous thrombosis (DVT). We describe two patients in whom free tissue transfer was attempted, following extensive resection of a sarcoma in the thigh. Both patients had been diagnosed with DVT prior to surgery and received therapeutic low molecular weight heparin preoperatively. In the first patient, flap failure occurred due to venous congestion initially resulting from poor flow in the reconstructed femoral vein and then thrombosis and failure of the vascular reconstruction. In the second patient the superficial venous system was used for successful microvascular anastomosis leading to survival of the flap. Therefore, patients undergoing lower extremity free tissue transfer who are at high risk of DVT, or when there is a clinical suspicion of DVT, thorough preoperative assessment of the deep and superficial venous system is warranted for reconstruction planning.

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Citations

Sep 15, 2011·Plastic and Reconstructive Surgery·Christopher J PannucciEdwin G Wilkins
Nov 26, 2010·Journal of the American College of Surgeons·Christopher J PannucciEdwin G Wilkins
Aug 24, 2010·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·Andrés Rodriguez LorenzoFu-Chan Wei
Apr 13, 2018·Plastic and Reconstructive Surgery·Jae-A JungMin Ji Kim

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