Milrinone Does Not Improve Free Flap Survival in Microvascular Surgery

Free flap microvascular surgery involves the transfer of a mobilised tissue flap with complete vascular reanastomosis at the new site. Ischaemia frequently threatens flap survival and may require a return to the operating theatre for anastomotic revision. Arterial spasm and hypoperfusion are recognised as factors in flap ischaemia. Phosphodiesterase inhibitors such as milrinone may improve flap blood flow and possibly flap survival by arterial dilation and increasing cardiac output. To investigate the role of milrinone in this type of surgery, a double-blinded randomised controlled trial was conducted with 88 patients receiving either a milrinone bolus and infusion throughout surgery or placebo (normal saline). We found that milrinone did not improve graft survival, return to theatre rate, or surgically graded arterial spasm, but did require more vasopressor support. We conclude that intraoperative milrinone did not improve flap outcomes in microvascular surgery.

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Comparison of PEAK PlasmaBlade™ to conventional diathermy in abdominal based free flap breast reconstruction surgery - a single centre double blinded randomised controlled trial

Journal of Plastic Reconstructive & Aesthetic Surgery ◽

10.1016/j.bjps.2020.12.007 ◽

2020 ◽

Author(s):

T.R. Friebel ◽

N. Narayan ◽

V. Ramakrishnan ◽

M. Morgan ◽

S Cellek ◽

...

Keyword(s):

Randomised Controlled Trial ◽

Breast Reconstruction ◽

Free Flap ◽

Controlled Trial ◽

Single Centre ◽

Reconstruction Surgery ◽

Randomised Controlled ◽

Double Blinded

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Faculty Opinions recommendation of A comparative study of varying doses of enoxaparin for thromboprophylaxis in critically ill patients: a double-blinded, randomised controlled trial.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.718006609.793477846 ◽

2013 ◽

Author(s):

David Kuter ◽

Rachel Rosovsky

Keyword(s):

Randomised Controlled Trial ◽

Comparative Study ◽

Critically Ill ◽

Critically Ill Patients ◽

Controlled Trial ◽

Randomised Controlled ◽

Double Blinded

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Faculty Opinions recommendation of The role of salt intake and salt sensitivity in the management of hypertension in South Asian people with chronic kidney disease: a randomised controlled trial.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.718019587.793481659 ◽

2013 ◽

Author(s):

David Goldsmith

Keyword(s):

Chronic Kidney Disease ◽

Randomised Controlled Trial ◽

Kidney Disease ◽

South Asian ◽

Salt Intake ◽

Controlled Trial ◽

Salt Sensitivity ◽

Randomised Controlled ◽

Asian People

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Faculty Opinions recommendation of Preoperative physiotherapy for the prevention of respiratory complications after upper abdominal surgery: pragmatic, double blinded, multicentre randomised controlled trial.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.732568173.793542775 ◽

2018 ◽

Author(s):

Michael O'Connor

Keyword(s):

Randomised Controlled Trial ◽

Abdominal Surgery ◽

Controlled Trial ◽

Respiratory Complications ◽

Upper Abdominal Surgery ◽

Upper Abdominal ◽

Randomised Controlled ◽

Double Blinded

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Mechanical bowel preparation and oral antibiotics versus mechanical bowel preparation only prior rectal surgery (MOBILE2): a multicentre, double-blinded, randomised controlled trial—study protocol

BMJ Open ◽

10.1136/bmjopen-2021-051269 ◽

2021 ◽

Vol 11 (7) ◽

pp. e051269

Author(s):

Laura Koskenvuo ◽

Pipsa Lunkka ◽

Pirita Varpe ◽

Marja Hyöty ◽

Reetta Satokari ◽

...

Keyword(s):

Randomised Controlled Trial ◽

Bowel Preparation ◽

Controlled Trial ◽

Rectal Surgery ◽

Mechanical Bowel Preparation ◽

Oral Antibiotic ◽

Oral Antibiotics ◽

Number Of Patients ◽

Randomised Controlled ◽

Double Blinded

IntroductionMechanical bowel preparation (MBP) prior to rectal surgery is widely used. Based on retrospective data many guidelines recommend mechanical and oral antibiotic bowel preparation (MOABP) to reduce postoperative complications and specifically surgical site infections (SSIs). The primary aim of this study is to examine whether MOABP reduces complications of rectal surgery.Methods and analysisThe MOBILE2 (Mechanical Bowel Preparation and Oral Antibiotics vs Mechanical Bowel Preparation Only Prior Rectal Surgery) trial is a multicentre, double-blinded, parallel group, superiority, randomised controlled trial comparing MOABP to MBP among patients scheduled for rectal surgery with colorectal or coloanal anastomosis. The patients randomised to the MOABP group receive 1 g neomycin and 1 g metronidazole two times on a day prior to surgery and patients randomised to the MBP group receive identical placebo. Based on power calculations, 604 patients will be enrolled in the study. The primary outcome is Comprehensive Complication Index within 30 days after surgery. Secondary outcomes are SSIs within 30 days after surgery, the number and classification of anastomosis dehiscences, the length of hospital stay, mortality within 90 days after surgery and the number of patients who received adjuvant treatment if needed. Tertiary outcomes are overall survival, disease-specific survival, recurrence-free survival and difference in quality-of-life before and 1 year after surgery. In addition, the microbiota differences in colon mucosa are analysed.Ethics and disseminationThe Ethics Committee of Helsinki University Hospital approved the study. The findings will be disseminated in peer-reviewed academic journals.Trial registration numberNCT04281667.

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