Draenert, Florian G. and Gosau, Martin and Al Nawas, Bilal (2010) Management of venous thrombosis in fibular free osseomusculocutaneous flaps used for mandibular reconstruction: clinical techniques and treatment considerations. HEAD & FACE MEDICINE, 6: 8. ISSN 1746-160X,
Full text not available from this repository. (Request a copy)Abstract
Background: Mandibular reconstruction by means of fibula transplants is the standard therapy for severe bone loss after subtotal mandibulectomy. Venous failure still represents the most common complication in free flap surgery. We present the injection of heparine into the arterial pedicle as modification of the revising both anastomoses in these cases and illustrate the application with a clinical case example. Methods: Methods consist of immediate revision surgery with clot removal, heparin perfusion by direct injection in the arterial vessel of the pedicle, subsequent high dose low-molecular weight heparin therapy, and leeches. After 6 hours postoperatively, images of early flap recovery show first sings of recovery by fading livid skin color. Results: The application of this technique in a patient with venous thrombosis resulted in the complete recovery of the flap 60 hours postoperatively. Other cases achieved similar success without additional lysis Therapy or revision of the arterial anastomosis. Conclusion: Rescue of fibular flaps is possible even in patients with massive thrombosis if surgical revision is done quickly.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | EXTERNAL JUGULAR-VEIN; HEAD; COMPLICATIONS; OSTEORADIONECROSIS; SALVAGE; SURGERY; |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Mund-, Kiefer- und Gesichtschirurgie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 17 Aug 2020 08:35 |
| Last Modified: | 17 Aug 2020 08:35 |
| URI: | https://pred.uni-regensburg.de/id/eprint/25468 |
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