Early survival of a compromised fasciocutaneous flap without pedicle revision: monitoring with photoplethysmography.

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

Microsurgery

journal_title

Microsurgery

authors

Chubb D,Rozen WM,Ashton MW

doi

10.1002/micr.20781

subject

Has Abstract

pub_date

2010-09-01 00:00:00

pages

462-5

issue

6

eissn

0738-1085

issn

1098-2752

journal_volume

30

pub_type

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