Archives of Plastic Surgery

  • 제48권5호
  • /
  • Pages.511-517
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  • 2021
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  • 2234-6163(pISSN)
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  • 2234-6171(eISSN)
대한성형외과학회 (Korean Society of Plastic and Reconstructive Surgeons)
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Primary thrombolysis for free flap surgery in head and neck reconstruction: a case report and review

  • Zhang, Steven Liben (Section of Plastic, Reconstructive and Aesthetic Surgery, Department of General Surgery) ;
  • Ng, Hui Wen (Section of Plastic, Reconstructive and Aesthetic Surgery, Department of General Surgery)
  • 투고 : 2021.01.16
  • 심사 : 2021.05.27
  • 발행 : 2021.09.15
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초록

The use of free flaps is an essential and reliable method of reconstruction in complex head and neck defects. Flap failure remains the most feared complication, the most common cause being pedicle thrombosis. Among other measures, thrombolysis is useful when manual thrombectomy has failed to restore flap perfusion, in the setting of late or established thrombosis, or in arterial thrombosis with distal clot propagation. We report a case of pedicle arterial thrombosis with distal clot propagation which occurred during reconstruction of a maxillectomy defect, and was successfully treated with thrombolysis using recombinant tissue plasminogen activator. We also review the literature regarding the use of thrombolysis in free flap surgery, and propose an algorithm for the salvage of free flaps in head and neck reconstruction.

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참고문헌

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  2. Chiu YH, Chang DH, Perng CK. Vascular complications and free flap salvage in head and neck reconstructive surgery: analysis of 150 cases of reexploration. Ann Plast Surg 2017;78(3 Suppl 2):S83-8. https://doi.org/10.1097/SAP.0000000000001011
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