文章基本信息

标题：Primary thrombolysis for free flap surgery in head and neck reconstruction: a case report and review
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作者：Steven Liben Zhang ; Hui Wen Ng
期刊名称：Archives of Plastic Surgery
印刷版ISSN：2234-6163
出版年度：2021
卷号：48
期号：5
页码：511-517
DOI：10.5999/aps.2021.00171
语种：English
出版社：The Korean Society of Plastic and Reconstructive Surgeons
摘要：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.