文章基本信息

标题：Salvage of late flap compromise in deep inferior epigastric perforator flaps: To revise or not to revise
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作者：Seung Heon Hong ; Kyeong-Tae Lee ; Jai-Kyong Pyon 等
期刊名称：Archives of Plastic Surgery
印刷版ISSN：2234-6163
出版年度：2020
卷号：47
期号：1
页码：97-101
DOI：10.5999/aps.2019.01578
出版社：The Korean Society of Plastic and Reconstructive Surgeons
摘要：Although the success rate of deep inferior epigastric perforator (DIEP) flaps has increased, late flap failures still occur and have a low salvage rate. The present article describes a case of salvage of a case of late flap failure using the pedicle vein as a vein graft source. A 50-year-old woman underwent a bilateral DIEP free flap procedure. On postoperative day 6, she experienced flap compromise and underwent emergency flap revision. In the flap revision, flap venous drainage and the superficial inferior epigastric vein were completely obstructed. A Fogarty catheter was used to remove a thrombus from the completely obstructed pedicle vein, and this pedicle vein was used as a graft source and was ligated in retrograde fashion to the flap vein stump. After injection of urokinase into the arterial branch, venous flow to the flap was restored. At a 6-month follow-up visit in the outpatient clinic, only partial fat necrosis at the flap was noted. By dissecting various perforators in the initial operation, decisions regarding immediate revision can be made with more confidence. Additionally, the combined procedures performed in this case may be helpful even for practitioners treating cases of late flap compromise.
关键词：Deep inferior epigastric perforator flap; Late flap failure; Pedicle vein graft