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

Archives of Plastic Surgery

Hui Wen Ng¹  Steven Liben Zhang¹ 

[1] Section of Plastic, Reconstructive and Aesthetic Surgery, Department of General Surgery, Tan Tock Seng Hospital, Singapore;

关键词: thrombolytic therapy;    free tissue flaps;    reconstructive surgical procedures;    surgery, plastic;    fibrinolytic agents;   

DOI  :  10.5999/aps.2021.00171

来源: DOAJ

【 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.

【 授权许可】

Unknown