Primary thrombolysis for free flap surgery in head and neck reconstruction: a case report and review

被引：1
|
作者：
Zhang, Steven Liben [1 ]
Ng, Hui Wen [1 ]
机构：
[1] Tan Tock Seng Hosp, Sect Plast Reconstruct & Aesthet Surg, Dept Gen Surg, 11 Jln Tan Tock Seng, Singapore 308433, Singapore
来源：
ARCHIVES OF PLASTIC SURGERY-APS | 2021年 / 48卷 / 05期
关键词：
Thrombolytic therapy; Free tissue flaps; Reconstructive surgical procedures; Surgery; plastic; Fibrinolytic agents; TISSUE-PLASMINOGEN ACTIVATOR; VASCULAR COMPLICATIONS; SALVAGE; THROMBOSIS;
D O I：
10.5999/aps.2021.00171
中图分类号：
R61 [外科手术学];
学科分类号：
摘要：
The use of free flaps is an essential and reliable method of reconstruction in complex head and neck defects. Flap failure remains the most feared complication, the most common cause being pedicle thrombosis. Among other measures, thrombolysis is useful when manual thrombectomy has failed to restore flap perfusion, in the setting of late or established thrombosis, or in arterial thrombosis with distal clot propagation. We report a case of pedicle arterial thrombosis with distal clot propagation which occurred during reconstruction of a maxillectomy defect, and was successfully treated with thrombolysis using recombinant tissue plasminogen activator. We also review the literature regarding the use of thrombolysis in free flap surgery, and propose an algorithm for the salvage of free flaps in head and neck reconstruction.
引用
收藏
页码：511 / 517
页数：7
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