Abstract:
:While free flaps are reliant on their vascular pedicle for survival intraoperatively and for a variable period of time postoperatively, there have been reports of late pedicle compromise after which complete flap survival has ensued. Successful neovascularization and revascularization at the edges of a flap in such cases result in the flap becoming independent of its pedicle. We report a case in which free flap survival occurred following pedicle compromise before postoperative day seven. The use of preoperative computed tomographic angiography (CTA) assessment to map flap vasculature was able to demonstrate the intrinsic vascular anatomy of the flap, and both clinical assessment and photoplethysmography (PPG) assessment of cutaneous blood flow obtained during and after flap compromise were able to highlight the changes in flap perfusion. With complete flap survival despite the lack of pedicle revision, the roles for close monitoring with clinical assessment and PPG, and delaying debridement are discussed.
journal_name
Microsurgeryjournal_title
Microsurgeryauthors
Chubb D,Rozen WM,Ashton MWdoi
10.1002/micr.20781subject
Has Abstractpub_date
2010-09-01 00:00:00pages
462-5issue
6eissn
0738-1085issn
1098-2752journal_volume
30pub_type
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