scholarly journals Short-term augmentation of venous drainage with extra-corporeal shunt and simultaneous auto-transfusion, for salvaging a congested free flap

2013 ◽  
Vol 46 (03) ◽  
pp. 572-576 ◽  
Author(s):  
Rahul K. Patil ◽  
Kiran Jayaprasad ◽  
Saurabh Sharma ◽  
Mohit Sharma ◽  
Jimmy Mathew
Keyword(s):  
Tibial Fracture ◽  
Venous Blood ◽  
Free Tissue Transfer ◽  
Venous Drainage ◽  
Anterolateral Thigh Flap ◽  
Short Term ◽  
Critical Part ◽  
Tissue Transfer ◽  
Anterolateral Thigh ◽  
Potential Applications

ABSTRACTAdequate drainage of venous blood is the most critical part of successful free tissue transfer. We report a case of anterolateral thigh flap used for covering open communited tibial fracture. The flap was salvaged with short term augmentation of venous drainage with external shunt. The drainage was continued for six days. It was confirmed that there is no more congestion after blocking the catheter and then the drainage was discontinued on seventh day. The flap was successfully salvaged. This method has potential applications in multiple situations for successful salvage of free tissue transfer.

scholarly journals Free Tissue Transfer Penile Reconstruction

2019 ◽  
Vol 33 (01) ◽  
pp. 024-029 ◽  
Author(s):  
Jason Cohn ◽  
Weitao Wang ◽  
Mofiyinfolu Sokoya ◽  
Yadranko Ducic ◽  
Bradley Kropp
Keyword(s):  
Free Tissue Transfer ◽  
Anterolateral Thigh Flap ◽  
Complete Excision ◽  
Advantages And Disadvantages ◽  
Tissue Transfer ◽  
Anterolateral Thigh ◽  
Gender Affirmation ◽  
Scapular Flap ◽  
Radial Forearm ◽  
And Gender

AbstractPhalloplasty can be a challenging plastic surgery procedure associated with complications and unsatisfactory results. Phalloplasty has become an important procedure in the setting of trauma, partial or complete excision of the penis, and gender affirmation. Advances in microsurgery has expanded penile reconstruction through free tissue transfer techniques which include the radial forearm free flap, fibular osteocutaneous flap, anterolateral thigh flap, latissimus dorsi flap, scapular flap, and abdominal flaps. Each procedure has advantages and disadvantages; most of the procedures achieve adequate cosmetic results with high patient satisfaction. Most of the surgical complications are related to the reconstruction of the urethra or creating rigidity for intercourse. The main goals of reconstruction are to create a cosmetically appealing phallus with satisfactory sexual function.

scholarly journals Innovative technique: Distal venous cannulation for salvaging free flap venous thrombosis by heparinised saline irrigation

2015 ◽  
Vol 48 (01) ◽  
pp. 054-056
Author(s):  
G. D. S. Kalra ◽  
Devidutta Mohanty ◽  
Ritesh Jain
Keyword(s):  
Venous Thrombosis ◽  
Venous Blood ◽  
Free Tissue Transfer ◽  
Free Flaps ◽  
Venous Cannulation ◽  
Saline Irrigation ◽  
Intravenous Cannula ◽  
Tissue Transfer ◽  
Potential Applications ◽  
Microvascular Free Flaps

ABSTRACT Introduction: Successful free tissue transfer depends on a multitude of factors, and adequate drainage of venous blood is one of the most critical part of successful free tissue transfers. Material and Methods: We report 6 cases of microvascular free flaps used for covering various defects, which developed venous congestion, that were salvaged with heparinised saline irrigation through the distal end of the congested vein by the help of an intravenous cannula. The irrigation was continued for 5 days. Results: All the flaps were successfully salvaged. Conclusion: This method has potential applications in situations for successful salvage of free tissue transfer particularly due to venous thrombosis.

scholarly journals Microvascular Free Tissue Transfer in the Reconstruction of Scalp and Lateral Temporal Bone Defects

2011 ◽  
Vol 4 (4) ◽  
pp. 179-187 ◽  
Author(s):  
Daniel A. O'Connell ◽  
Marita S. Teng ◽  
Eduardo Mendez ◽  
Neal D. Futran
Keyword(s):  
Temporal Bone ◽  
Case Series ◽  
Free Tissue Transfer ◽  
Wound Dehiscence ◽  
Free Flaps ◽  
Bone Defects ◽  
Unique Challenge ◽  
Cosmetic Results ◽  
Tissue Transfer ◽  
Anterolateral Thigh

Defects of the scalp and lateral temporal bone (LTB) represent a unique challenge to the reconstructive surgeon. Simple reconstructive methods such as skin grafts, locoregional flaps, or tissue expanders are often not feasible due to a myriad of reasons. Vascularized free tissue transfer coverage offers distinct advantages in managing these defects. A retrospective case series was performed on all patients at the University of Washington Medical Center who had scalp or LTB defects reconstructed with free tissue transfer from May 1996 to July 2009. Cases were analyzed for defect characteristics, flap type, vessel selection, radiation status, dural exposure, complications, and outcomes. Sixty-eight free flaps were performed in 65 patients with scalp or LTB defects. Twenty-two resections included craniotomy, and 48 patients had pre- or postoperative radiation. Defects ranged from 6 to 836 cm2. All flaps (46 latissimus, 11 rectus, 4 radial forearm, 6 anterolateral thigh, and 1 omental) were transferred successfully. Vein grafts were required in five cases. Complications included delayed flap failure requiring secondary reconstruction, neck hematoma, venous thrombosis, skull base infection, large wound dehiscence, small wound dehiscence, donor site hematoma and seroma, and cerebrospinal fluid leak. Cosmetic results were consistent and durable. Microvascular free tissue transfer is a safe, reliable method of reconstructing scalp and LTB defects and offers favorable cosmetic results. We favor the use of latissimus muscle-only flap with skin graft coverage for large scalp defects and rectus or anterolateral thigh free flaps for lateral temporal bone defects.

scholarly journals Protocol for a Systematic Review of Outcomes From Microsurgical Free Tissue Transfer Performed on Short-term Surgical Missions in Low-income and Middle-income Countries

2021 ◽  
Author(s):  
Henry Tobias de Berker ◽  
Urška Čebron ◽  
Daniel Bradley ◽  
Vinod Patel ◽  
Meklit Berhane ◽  
...  
Keyword(s):  
Systematic Review ◽  
Free Flap ◽  
Low Income ◽  
Free Tissue Transfer ◽  
Risk Of Bias ◽  
Study Quality ◽  
Short Term ◽  
Middle Income ◽  
Middle Income Countries ◽  
Tissue Transfer

Abstract Background: In many units around the world, microsurgical free tissue transfer represents the gold standard for reconstruction of significant soft tissue defects following cancer, trauma or infection. However, many reconstructive units in low-income and middle-income countries (LMICs) do not yet have access to the resources, infrastructure or training required to perform any microsurgical procedures. Long-term international collaborations have been formed with annual short-term reconstructive missions conducting microsurgery. In the first instance, these provide reconstructive surgery to those who need it. In the longer-term, they offer an opportunity for teaching and the development of sustainable local services.Methods: A PRISMA-compliant systematic review and meta-analysis will be performed. A comprehensive, predetermined search strategy will be applied to the MEDLINE and Embase electronic databases from inception to December 2020. All clinical studies presenting sufficient data on free tissue transfer performed on short-term surgical missions (STSMs) in LMICs will be eligible for inclusion. The primary outcomes are rate of free flap failure, rate of emergency return to theatre for free flap salvage and successful salvage rate. The secondary outcomes include postoperative complications and any functional or patient reported outcome measures. Screening of studies, data extraction and assessments of study quality and bias will be conducted by two authors. Individual study quality will be assessed according to the Oxford Evidence-based Medicine Scales of Evidence 2, and risk of bias using either the ‘Revised Cochrane risk of bias tool for randomized trials’ (Rob2), or the ‘Risk of bias in non-randomized studies of interventions’ (ROBINS-I) tools. Overall strength of evidence will be assessed according to the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach.Discussion: To-date the outcomes of microsurgical procedures performed on STSMs to LMICs are largely unknown. Improved education, funding and allocation of resources are needed to support surgeons in LMICs to perform free tissue transfer. STSMs provide a vehicle for sustainable collaboration and training. Disseminating microsurgical skills could improve the care received by patients living with reconstructive pathology in LMICs, but this is poorly established. This study sets out a robust protocol for a systematic review designed to critically analyse outcomes. Systematic review registration: Submitted to PROSPERO (15/12/20 ID: 225613)

Antegrade Venous Drainage in a Reverse-Flow Anterolateral Thigh Flap

2009 ◽  
Vol 124 (5) ◽  
pp. 273e-274e ◽  
Author(s):  
Cheng-Hung Lin ◽  
Chung-Chen Hsu ◽  
Chih-Hung Lin ◽  
Yi-Chieh Chen ◽  
Fu-Chan Wei
Keyword(s):  
Reverse Flow ◽  
Venous Drainage ◽  
Anterolateral Thigh Flap ◽  
Anterolateral Thigh
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