Journal of reconstructive microsurgery
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J Reconstr Microsurg · Jul 2013
Review Comparative StudyPerioperative fluid management and use of vasoactive and antithrombotic agents in free flap surgery: a literature review and clinical recommendations.
After reading this article, the participant should be able to (1) outline the rationale for different perioperative types of fluid therapy in free flap surgery and identify the methods considered best for flap survival; (2) understand the current views on the use of vasoactive agents and consider its possible safe use; (3) compare the most commonly used intraoperative and postoperative anticoagulant therapies and identify the risks and benefits associated with each. ⋯ Free flap surgery has become a reliable and efficient method for reconstruction of complex soft tissue and bony defects. Despite high success rates, free flap failure remains an important concern. A review of the literature was conducted on nonsurgical factors that may contribute to flap failure or success. Various anesthesiological and anticoagulant methods are applied in free flap surgery, but for the ideal approach there is no consensus. This article provides clinical recommendations on perioperative fluid management and the use of vasoactive and antithrombotic agents and offers a balanced view on the risks and benefits.
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J Reconstr Microsurg · Jul 2013
A retrospective review of outcomes and flap selection in free tissue transfers for complex lower extremity reconstruction.
Complex lower extremity wounds present a significant challenge to the reconstructive surgeon. We report a consecutive experience of free tissue transfers for lower extremity reconstruction with a focus on outcomes and flap selection. ⋯ Patient comorbidities and defect location can be associated with higher rates of complications; flap selection and delayed venous thrombotic events appear to be associated with flap failure.Level of Evidence Prognostic/risk category, level III.
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J Reconstr Microsurg · Jul 2013
Proximal-based saphenous neurocutaneous flaps: a novel tool for reconstructive surgery in the proximal lower leg and knee.
Soft tissue defects around the knee region are usually complex and require adequate reconstruction with flaps. In this article, we present our experience using the proximal-based saphenous neurocutaneous flap for the reconstruction of soft tissue defects around the knee and the proximal lower leg. ⋯ Our experience has demonstrated that the proximal-based saphenous neurocutaneous flap is a safe and reliable tool for reconstruction of the defects around the proximal lower leg and knee.