After microvascular free tissue transfer, neovascularization sufficient to maintain flap viability independent of the primary vascular pedicle may occur by postoperative day 9. This early revascularization can also occur despite a history of radiotherapy.
The complication of esophageal perforation after anterior cervical spine fusion for cervical spine disease is rare but potentially fatal. We describe two cases of esophageal perforation found by esophagoscopic visualization. In one patient, primary closure could not be achieved, and a submental island flap was used to repair the defect. In the second patient, primary closure was achieved and a pectoralis major flap was interposed between the closure and the residual instrumentation. Postoperatively, both patients had no evidence of persistent perforation and had resolution of preoperative symptoms.
Using a microvenous tuck model set-up for anastomotic failure, we found no difference in the rate of thrombosis or the time to thrombosis in rats pretreated with aspirin, clopidogrel, or ketorolac.
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