Dextrans in microsurgery: A review

Abstract

This articles reviews the use of dextrans in free tissue transfer. Current recommended regimes, indications, and complications are discussed. In conclusion, dextrans cannot be used as a substitute for good surgical technique, and should be utilized cautiously, especially in the elderly.

Other microbial polysaccharides: pullulan, scleroglucan, elsinan, levan, alternant, dextran

“…In gum and jelly candies they are used as gelling agents. In ice cream they are applied as crystallization inhibitors, while in pudding mixes they provide the desirable body and mouthfeel (Whistler and Daniel, 1990;Day and Kim, 1993;Jallali, 2003;Khan et al, 2007). Different ester and ether derivatives of dextran furnish macromolecules with diverse properties and negative, positive, or neutral charges.…”

“…Sephadex Õ is used as a molecular sieve which brought revolution to the purification and separation technology of various biological macromolecules such as proteins, nucleic acids, and polysaccharides. Dextrans are also an essential component of various Sephadex derivatives (Jallali, 2003). Dextrans have many other potential applications such as emulsifying and thickening agents, high-viscosity gums, explosives, deflocculants in paper products, secondary recovery of petroleum, oil drilling muds, soil conditioners and surgical sutures (Whistler and Daniel, 1990).…”

“…Moreover, patents have been granted related to the use of dextran preparations in baked products (Jallali, 2003).…”

Surgical reconstruction in patients with cancer of the head and neck

“…Recent technological advances have made it possible to perform anastomoses between the vessels of the flap pedicle and the recipient vessels in a shorter time by using microvascular anastomotic coupler devices [23]. A variety of methods are available for increasing the patency rate of microvascular anastomoses in free flap reconstruction, including administration of perioperative dextran, aspirin, or heparin [24][25][26]. Extensive research is underway to increase the survival rates of patients with free flaps who experience vascular compromise through chemical and pharmacologic manipulation because loss of a free flap is a highly morbid and costly event [27].…”

A Survey of U.K. Units and a Suggested Protocol for Free Flap Reconstruction of the Lower Limb: Follow-up and Management in the First Postoperative Week

“…Dextran is also a volume expander and thus may cause fluid overload, such as pulmonary edema, and administration requires caution. 11 These supportive procedures help a flap failing due to venous embarrassment. A failing flap is returned to the operating theater as soon as possible.…”