Hand: Microsurgery and Flaps

Vascular complications and microvascular free flap salvage: the role of thrombolytic agents

Chang EI, Mehrara BJ, Festekjian JH, et al (UCLA Med Ctr; Memorial Sloan-Kettering Cancer Ctr, NY) Microsurgery 31:505-509, 2011^§

Abstract

Background

Vascular thrombosis with flap loss is the most dreaded complication of microvascular free tissue transfer. Thrombolytic agents such as tissue plasminogen activator have been used clinically for free flap salvage in cases of pedicle thrombosis. Yet, there is a paucity of data in the literature validating the benefit of their use.

Methods

A retrospective review of the breast reconstruction free flap database was performed at a single institution between the years of 1991–2010. The incidence of vascular complications (arterial and/or venous thrombosis) was examined to determine the role of adjuvant thrombolytic therapy in flap salvage. Pathologic examination was used to determine the incidence of fat necrosis after secondary revision procedures.

Results

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