Methods of Assessing the Viability of Free Flap Transfer During the Postoperative Period

1983 ◽  
Vol 10 (1) ◽  
pp. 21-36 ◽  
Author(s):  
Douglas H. Harrison ◽  
Marjorie Girling ◽  
Godfrey Mott
Author(s):  
George A. Beyer ◽  
Karan Dua ◽  
Neil V. Shah ◽  
Joseph P. Scollan ◽  
Jared M. Newman ◽  
...  

Abstract Introduction We evaluated the demographics, flap types, and 30-day complication, readmission, and reoperation rates for upper extremity free flap transfers within the National Surgical Quality Improvement Program (NSQIP) database. Materials and Methods Upper extremity free flap transfer patients in the NSQIP from 2008 to 2016 were identified. Complications, reoperations, and readmissions were queried. Chi-squared tests evaluated differences in sex, race, and insurance. The types of procedures performed, complication frequencies, reoperation rates, and readmission rates were analyzed. Results One-hundred-eleven patients were selected (mean: 36.8 years). Most common upper extremity free flaps were muscle/myocutaneous (45.9%) and other vascularized bone grafts with microanastomosis (27.9%). Thirty-day complications among all patients included superficial site infections (2.7%), intraoperative transfusions (7.2%), pneumonia (0.9%), and deep venous thrombosis (0.9%). Thirty-day reoperation and readmission rates were 4.5% and 3.6%, respectively. The mean time from discharge to readmission was 12.5 days. Conclusion Upper extremity free flap transfers could be performed with a low rate of 30-day complications, reoperations, and readmissions.


2020 ◽  
pp. 1-2
Author(s):  
Michael Alperovich ◽  
Eric Park ◽  
Michael Alperovich ◽  
Omar Allam ◽  
Paul Abraham

Although sickle cell disease has long been viewed as a contraindication to free flap transfer, little data exist evaluating complications of microsurgical procedures in the sickle cell trait patient. Reported is the case of a 55-year-old woman with sickle cell trait who underwent a deep inferior epigastric perforator (DIEP) microvascular free flap following mastectomy. The flap developed signs of venous congestion on postoperative day two but was found to have patent arterial and venous anastomoses upon exploration in the operating room. On near-infrared indocyanine green angiography, poor vascular flow was noted despite patent anastomoses and strong cutaneous arterial Doppler signals. Intrinsic microvascular compromise or sickling remains a risk in the sickle cell trait population as it does for the sickle cell disease population. Just like in sickle cell disease patients, special care should be taken to optimize anticoagulation and minimize ischemia-induced sickling for patients with sickle cell trait undergoing microsurgery.


2018 ◽  
Vol 6 (11) ◽  
pp. e1913 ◽  
Author(s):  
Mohammad S. Radwan ◽  
Ammar Z. Barakat ◽  
Mohammad M. Jaber ◽  
Ashraf A. Mashal

Microsurgery ◽  
1984 ◽  
Vol 5 (2) ◽  
pp. 102-104 ◽  
Author(s):  
Leonard K. Ruby ◽  
Mark Greene ◽  
Giovanni Risitand ◽  
Ricardo Torrejon ◽  
Mark R. Belsky

Microsurgery ◽  
1992 ◽  
Vol 13 (4) ◽  
pp. 208-213 ◽  
Author(s):  
Xiaolu Li ◽  
Brian C. Cooley ◽  
Suzann M. Gruel ◽  
Zhong Ye ◽  
John S. Gould

Hand Clinics ◽  
1985 ◽  
Vol 1 (2) ◽  
pp. 297-309
Author(s):  
Yoshikazu Ikuta

1998 ◽  
Vol 102 (4) ◽  
pp. 1188-1192 ◽  
Author(s):  
Raymund E. Horch ◽  
Max Meyer-Marcotty ◽  
Björn G. Stark

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