scholarly journals Improvised perioperative techniques to meet the challenges of microvascular free flap surgery

2016 ◽  
Vol 3 (2) ◽  
pp. 99-100
Author(s):  
Soumi Pathak ◽  
Itee Chowdhury ◽  
Ajay Kumar Bhargava
Keyword(s):  
Free Flap ◽  
Neck Region ◽  
Flap Surgery ◽  
Surgical Morbidity ◽  
Head And Neck Region ◽  
Form And Function ◽  
Free Flap Surgery ◽  
And Function ◽  
Microvascular Free Flap

Deformities of the head and neck region after radical oncosurgery can have devastating effects on the appearance of the patient with significant impact on patients quality of life. Reconstruction of such defects continues to be an extremely demanding challenge for plastic surgeons who aim to restore form and function with minimal surgical morbidity. The purpose of this communications is to highlight the various interventions and the protocols that are adopted to decrease the free flap failure rate.  

One versus Two Venous Anastomoses in Microvascular Free Flap Surgery

2011 ◽  
Vol 127 (6) ◽  
pp. 2514-2515 ◽  
Author(s):  
Warren M. Rozen ◽  
Iain S. Whitaker ◽  
Rafael Acosta
Keyword(s):  
Free Flap ◽  
Flap Surgery ◽  
Free Flap Surgery ◽  
Microvascular Free Flap

Reply: One versus Two Venous Anastomoses in Microvascular Free Flap Surgery

2011 ◽  
Vol 127 (6) ◽  
pp. 2515-2516
Author(s):  
Matthew M. Hanasono ◽  
Ergun Kocak ◽  
Olubunmi Ogunleye ◽  
Craig J. Hartley ◽  
Michael J. Miller
Keyword(s):  
Free Flap ◽  
Flap Surgery ◽  
Free Flap Surgery ◽  
Microvascular Free Flap

A Prospective Study of Microvascular Free-Flap Surgery and Outcome

1998 ◽  
Vol 102 (3) ◽  
pp. 711-721 ◽  
Author(s):  
Roger K. Khouri ◽  
Brian C. Cooley ◽  
Allen R. Kunselman ◽  
J. Richard Landis ◽  
Patrick Yeramian ◽  
...  
Keyword(s):  
Prospective Study ◽  
Free Flap ◽  
Flap Surgery ◽  
Free Flap Surgery ◽  
A Prospective Study ◽  
Microvascular Free Flap

scholarly journals Potential Effect of Two Different Anaesthesia Techniques on the Activation of Hhv-6 and Hhv-7 Infection in Relation to Changes in Total Lymphocyte Count and Peripheral Immune Cell Distribution after Prolonged Microvascular Free Flap Surgery / Divu Atšķirîgu Anestēzijas Metožu Ietekme Uz Hhv-6 Un Hhv-7 Infekcijas Aktivāciju Saistībā Ar Limfocītu Skaitu Izmaiņām Un Perifēro Imūno Šūnu Sadali Pēc Ilgstošām Mikrovaskulārām Brīvo Lēveru Operācijām

2014 ◽  
Vol 68 (5-6) ◽  
pp. 216-221
Author(s):  
Arnis Vilks ◽  
Santa Rasa ◽  
Simona Doniņa ◽  
Modra Murovska ◽  
Biruta Mamaja
Keyword(s):  
Free Flap ◽  
Lymphocyte Count ◽  
Immune Cell ◽  
Total Lymphocyte Count ◽  
Cell Distribution ◽  
Flap Surgery ◽  
Total Lymphocyte ◽  
Free Flap Surgery ◽  
Peripheral Immune Cell ◽  
Microvascular Free Flap

Abstract Microvascular free flap surgery is a complex method of wound closure for large wounds. Tissue trauma, surgical stress and general anaesthesia are known immunosuppressors that may exacerbate postoperative infections. Beta-herpesviruses HHV-6 and HHV-7 are immunomodulating viruses highly prevalent in the population of healthy individuals, which can interfere with the function of the host immune system. These viruses can be reactivated in immunosuppressed conditions. The aim of this study was to monitor the potential effects of two different anaesthesia techniques - general anaesthesia (GA) and regional anaesthesia (RA) - on the activation of HHV-6 and HHV-7 infection in relation to changes in the total lymphocyte count and peripheral immune cell distribution after microvascular free flap surgery. We found significant increase in the frequency of active HHV-7 infection after surgery (p < 0.05) in the GA group. In the RA group changes were not significant. The activation of HHV-7 infection was associated with decrease in the total lymphocyte count post-operatively in patients from the GA group. The data of our study show that reconstructive flap surgery under GA is linked with more frequent postoperative lymphopenia, which is a potential post-operative immunosuppressor that probably triggers the activation of HHV-6 and HHV-7 infection

scholarly journals One versus Two Venous Anastomoses in Microvascular Free Flap Surgery

2010 ◽  
Vol 126 (5) ◽  
pp. 1548-1557 ◽  
Author(s):  
Matthew M. Hanasono ◽  
Ergun Kocak ◽  
Olubunmi Ogunleye ◽  
Craig J. Hartley ◽  
Michael J. Miller
Keyword(s):  
Free Flap ◽  
Flap Surgery ◽  
Free Flap Surgery ◽  
Microvascular Free Flap

A Prospective Study of Microvascular Free-Flap Surgery and Outcome

1998 ◽  
Vol 102 (3) ◽  
pp. 711-721 ◽  
Author(s):  
Roger K. Khouri ◽  
Brian C. Cooley ◽  
Allen R. Kunselman ◽  
Richard J. Landis ◽  
Patrick Yeramian ◽  
...  
Keyword(s):  
Prospective Study ◽  
Free Flap ◽  
Flap Surgery ◽  
Free Flap Surgery ◽  
A Prospective Study ◽  
Microvascular Free Flap

A UK based multi-centre prospective study of microvascular free-flap surgery

2020 ◽  
Vol 43 (6) ◽  
pp. 767-772
Author(s):  
Hywel Room ◽  
Oliver Sawyer ◽  
Claire Sethu ◽  
Hisham Taha ◽  
Jurga Pikturnaite ◽  
...  
Keyword(s):  
Prospective Study ◽  
Free Flap ◽  
Flap Surgery ◽  
Free Flap Surgery ◽  
Microvascular Free Flap

scholarly journals Health-related quality of life, surgical and aesthetic outcomes following microvascular free flap reconstructions: an 8-year institutional review

2012 ◽  
Vol 94 (1) ◽  
pp. 43-51 ◽  
Author(s):  
RT Dolan ◽  
JS Butler ◽  
SM Murphy ◽  
KJ Cronin
Keyword(s):  
Quality Of Life ◽  
Free Flap ◽  
Short Form ◽  
Health Related Quality ◽  
Tertiary Referral Centre ◽  
Free Flap Surgery ◽  
Related Quality ◽  
Health Related ◽  
Microvascular Free Flap

INTRODUCTION Microvascular free flap reconstruction has revolutionised the reconstruction of complex defects of traumatic, oncological, congenital and infectious aetiologies. Complications of microvascular free flap procedures impact negatively on patient post-operative course and outcome. METHODS We performed a retrospective analysis of 102 consecutive patients undergoing 108 free flap procedures at a tertiary referral centre over an 8-year period. Logistic regression analysis was used to identify factors pRedictive of free flap complications. Health-related quality of life (HRQoL) and aesthetic outcomes were assessed using the Short Form 36 questionnaire and a satisfaction visual analogue scale respectively. RESULTS In total, 108 free tissue transfers were performed; 23% were fasciocutaneous free flaps, 69% musculocutaneous and 8% osteoseptocutaneous. The overall flap success rate was 92.6%. Over a third of patients (34.3%) had flap-related complications ranging from minor wound dehiscence to total flap loss. ASA (American Society of Anesthesiologists) grade ≥2 (OR: 16.9, 95% CI: 15.3–18.1, p<0.009), history of smoking (OR: 6.1, 95% CI: 5.5–7.2, p<0.049), body mass index ≥25kg/ m2 (OR: 21.3, 95% CI: 20.8–22.1, p<0.003), low albumin (odds ratio [OR]: 2.2, 95% confidence interval [CI]: 1.2–3.9, p<0.003) and peripheral vascular disease (OR: 6.9, 95% CI: 5.9–7.5, p<0.036) were identified as factors independently predictive of free flap complications. CONCLUSIONS Patients undergoing uncomplicated free flap surgery and those reporting superior post-operative flap aesthesis have higher HRQoL scores. Microvascular free tissue transfer has revolutionised our approach to the reconstruction of complex defects, providing a safe, reliable procedure to restore functionality and quality of life for patients.

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