Prevention of thrombosis after microvascular tissue transfer in the head and neck. A review of the literature and the state of affairs in Dutch Head and Neck Cancer Centers

Brands, Marieke T.; Bosch, S.C. van den; Dieleman, F.J.; Bergé, Stefaan; Merkx, Matthias A.W.

doi:10.1016/j.ijom.2009.11.020

Cited by 58 publications

(56 citation statements)

References 36 publications

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“…The ratio of vascular thrombosis reported in free flap surgery varies between 5.1% and 9.9% (11-13), and for the prevention of this complication, in addition to the suggestions of agents such as botulinum toxins, low molecular weight heparins, aspirin, prostaglandins, dextran inhibitors, and other various agents (14)(15)(16)(17)(18)(19)(20)(21)(22), studies on anastomosis have also been carried out (23)(24)(25)(26)(27)(28)(29).…”

Section: Discussionmentioning

confidence: 99%

An Attempt to Keep Flaps Alive with Artificial Perfusion in Rabbits

Özyazgan¹,

Idaci²,

Kontaş³

2016

Erciyes Med J

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Objective: In free flap surgery, the condition of recipient vessels may not be appropriate for anastomosis because of anatomical factors or acquired features such as tumoral invasion, surgical treatment, or radiotherapy. Furthermore, free flap surgery is time-consuming, expensive, demanding, and more prone to complications. The aim of this study was to test the hypothesis that maintaining free flap perfusion with a temporary artificial system without microanastomosis until revascularization is adequate for flap vitality. Materials and Methods:We studied a total of 14 rabbits, which were placed into two groups: control and experimental. A 5×5 cm free skin island flap was elevated on the caudolateral scapular region. In the experimental group, the artery and vein of the flaps were cannulated and a 5 cc/h plasma infusion was artificially started prior to flap fixation. In the control group, the flaps were designed and sutured to the recipient area without perfusion.Results: The animals did not live long enough for us to analyze the maintenance of the clinical flap vitality. However, it was found that flap tissues in the experimental group were vital during the first 6 days after surgery, while composite graft tissues in the control group resulted in necrosis on day 3 in histopathological examination.Conclusion: Our experimental model proves that the artificial flap perfusion model with plasma perfusion extends the duration of tissue viability compared with that with non-perfusion (control group). This result could be improved with further investigations and may lead to the development of many future innovations.

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Section: Discussionmentioning

confidence: 99%

An Attempt to Keep Flaps Alive with Artificial Perfusion in Rabbits

Özyazgan¹,

Idaci²,

Kontaş³

2016

Erciyes Med J

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“…In 2010, Brands 21 conducted a review of the literature which showed that there is currently no consensus in the literature to prevent thrombosis after microvascular free flap reconstruction. Conclusions were drawn that non-pharmacologic means such as smoking cessation and meticulous microvascular surgery plays a crucial role in the outcome.…”

Section: No Evidence Of Efficacymentioning

confidence: 99%

Prevention of Microsurgical Thrombosis

Shridharani¹,

Folstein²,

Chung³

et al. 2012

Current Concepts in Plastic Surgery

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“…In a recent review of multiple centers in the Netherlands, no single protocol for pharmacological thrombosis prevention could be defined. The authors emphasize the role of preoperative smoke cessation and careful vascular handling during surgery with an individualized postoperative treatment based on risk profile (Brands et al, 2009). …”

Section: Risk Factors and Complications Of Free Flap Oral Reconstructionmentioning

confidence: 99%