Abstract:
:Despite the high success rate of free-tissue transfer, thrombosis still complicates 5-30% of cases. Meticoulous technique, careful vessel selection, and pharmacological prophylaxis are not always enough to avoid thrombosis. Early diagnosis and reintervention provide the only way to salvage a thrombosed free flap, in case of either arterial or venous thrombosis. When kinking, torsion, or external compression of the pedicle are ruled out, and thrombectomy and redo of the anastomosis are unsuccessful, the last resort to save the flap is thrombolytic therapy. The authors present their experience with the salvage of two otherwise lost flaps by means of urokinase thrombolysis through direct intra-arterial injection with the vein left open to avoid systemic diffusion of the drug, and give technical tips to improve drug delivery to the flap. Pharmacological thrombolysis is an additional and effective weapon to resolve thrombosis, if properly used, to be considered by every reconstructive microsurgeon.
journal_name
Microsurgeryjournal_title
Microsurgeryauthors
D'Arpa S,Cordova A,Moschella Fdoi
10.1002/micr.20147subject
Has Abstractpub_date
2005-01-01 00:00:00pages
477-80issue
6eissn
0738-1085issn
1098-2752journal_volume
25pub_type
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