AffiliationDepartment of Plastic Surgery, University College Hospital, Galway, Newcastle, Ireland.
MeSHAnalysis of Variance
MetadataShow full item record
CitationProspective evaluation of outcome measures in free-flap surgery. 2004, 20 (6):435-8; discussion 439 J Reconstr Microsurg
JournalJournal of reconstructive microsurgery
AbstractFree-flap failure is usually caused by venous or arterial thrombosis. In many cases, lack of experience and surgical delay also contribute to flap loss. The authors prospectively analyzed the outcome of 57 free flaps over a 28-month period (January, 1999 to April, 2001). The setting was a university hospital tertiary referral center. Anastomotic technique, ischemia time, choice of anticoagulant, and the grade of surgeon were recorded. The type of flap, medications, and co-morbidities, including preoperative radiotherapy, were also documented. Ten flaps were re-explored (17 percent). There were four cases of complete flap failure (6.7 percent) and five cases of partial failure (8.5 percent). In patients who received perioperative systemic heparin or dextran, there was no evidence of flap failure (p = .08). The mean ischemia time was similar in flaps that failed (95 +/- 29 min) and in those that survived (92 +/- 34 min). Also, the number of anastomoses performed by trainees in flaps that failed (22 percent), was similar to the number in flaps that survived (28 percent). Nine patients received preoperative radiotherapy, and there was complete flap survival in each case. This study reveals that closely supervised anastomoses performed by trainees may have a similar outcome to those performed by more senior surgeons. There was no adverse effect from radiotherapy or increased ischemia time on flap survival.
- A prospective study of microvascular free-flap surgery and outcome.
- Authors: Khouri RK, Cooley BC, Kunselman AR, Landis JR, Yeramian P, Ingram D, Natarajan N, Benes CO, Wallemark C
- Issue date: 1998 Sep
- Effects of late loss of arterial inflow on free flap survival.
- Authors: Salgado CJ, Smith A, Kim S, Higgins J, Behnam A, Herrera HR, Serletti JM
- Issue date: 2002 Oct
- Role of thrombolysis in free-flap salvage.
- Authors: Panchapakesan V, Addison P, Beausang E, Lipa JE, Gilbert RW, Neligan PC
- Issue date: 2003 Nov
- Clinical experience with non-penetrating vascular clips in free-flap reconstructions.
- Authors: Zeebregts C, Acosta R, Bölander L, van Schilfgaarde R, Jakobsson O
- Issue date: 2002 Mar
- Venous anastomoses using microvascular coupler in free flap head and neck reconstruction.
- Authors: Zhang T, Lubek J, Salama A, Caccamese J, Coletti D, Dyalram D, Ord R
- Issue date: 2012 Apr