The British journal of oral & maxillofacial surgery
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Br J Oral Maxillofac Surg · Sep 2009
ReviewPostoperative monitoring of microsurgical free-tissue transfers for head and neck reconstruction: a systematic review of current techniques--part II. Invasive techniques.
A systematic review of the literature relating to methods of monitoring viability of microvascular free-tissue transfers in the head and neck region was conducted. The aim of this review is to identify the best method of monitoring that would allow timely salvage of potentially failing free flaps. An analysis and description of the various studied techniques is also given. In this second part, invasive modalities are covered.
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Br J Oral Maxillofac Surg · Sep 2009
Case ReportsHigh output chyle leak after neck surgery: the role of video-assisted thoracoscopic surgery.
Injury to the thoracic duct leading to formation of a chylous fistula is an infrequent but serious complication of major neck surgery that can result in a prolonged stay in hospital, and may lead to fluid, electrolyte, protein, and immune disturbances. Healing can also be impaired. We describe a case where an excessive chylous leak also contributed to the failure of two free flaps in the same patient, and we make recommendations regarding management of patients with free tissue transfer where this complication arises.