کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
4119804 1270362 2010 7 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Long term study into surgical re-exploration of the ‘free flap in difficulty’
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی بیماری های گوش و جراحی پلاستیک صورت
پیش نمایش صفحه اول مقاله
Long term study into surgical re-exploration of the ‘free flap in difficulty’
چکیده انگلیسی

SummaryBackgroundFree tissue transfers must survive in order to achieve their surgical goals. There is little consensus about managing the ‘failing’ free flap, and practice is often guided by anecdote.Material and methodsWe have prospectively collected data about all free flaps performed within our department between 1985 and 2008 (2569 flaps). We identified 327 flaps which were re-explored a total of 369 times. We analysed these flaps with regard to indication for re-exploration, operative findings and outcome.ResultsThirteen percent (327) of free flaps were re-explored. Of these, 291 (83%) had a successful outcome. Successful re-explorations took place at a mean 19 h post-op and unsuccessful re-explorations at a mean 56 h post-op. Clinical diagnosis prior to re-exploration was confirmed operatively in 91% of cases.ConclusionWe have considered the factors that allowed us to achieve the salvage rates described over a prolonged period, and identified two key areas. Firstly, we favour a model for free flap monitoring with clinical judgement at its core. Secondly, we feel the facility to recover patients post-operatively in a specialised, warmed environment, and return them to theatre quickly should the need arise, is essential. These two simple, yet institutionally determined factors are vital for maintaining excellent success rates.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Journal of Plastic, Reconstructive & Aesthetic Surgery - Volume 63, Issue 7, July 2010, Pages 1080–1086
نویسندگان
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