Minimally invasive late free flap salvage: indications, efficacy and implications for reconstructive microsurgeons.
NS Anavekar, E Lim, A Johnston, M Findlay, DJ Hunter-Smith
J Plast Reconstr Aesthet Surg | Published : 2011
One of the most common causes of free flap compromise is microvascular thrombosis. Acland et al describe two described zones of injury: zone 1 the anastomotic site and zone 2 downstream. Factors contributing to zone 1 thromboses include anastomotic irregularities, suture material and platelet adhesion. This often presents in the early postoperative period. Zone 2 however, is less well described and is associated with diffuse microvascular ischaemia. Often, these cases are associated with the use of vein grafts in a delayed reconstructive setting, and present relatively late in their postoperative follow up. There are sporadic reports in the literature of late free flap salvage managed via an..View full abstract