CASE REPORT Superior Gluteal Artery Perforator Flap Breast Reconstruction Salvage Following Late Venous Congestion After Discharge.
Research article published in Eplasty (2010)
Abstract
OBJECTIVE: Microvascular thrombosis is a dreaded complication of free tissue transfer, especially in breast reconstruction. Failure often leads to complete loss of the reconstruction and affects the patient both physically and psychologically. Fortunately, most vascular compromises occur early (within 24-36 hours) while the patient is still in the hospital and intervention takes place prior to irreversible thrombosis of the microvasculature. However, failures beyond 96 hours generally have dismal prognosis, especially because the patient is already home. METHODS: A case of successful salvage is reported after an uncomplicated superior gluteal artery perforator flap performed for breast reconstruction returned from home with thrombosis of the venous pedicle the morning of postoperative day 5. RESULTS: The pedicle was promptly explored and the venous patency reestablished using a combination of mechanical and chemical thrombolysis. At her 2-year follow-up, there was no evidence of fat necrosis and a satisfactory aesthetic outcome was achieved. CONCLUSION: Late salvage of failing free flap breast reconstruction from home is possible. Educating the patient on importance of self-examination is critical to salvage. The hospital system also needs to have the resources to handle such emergencies in order for rapid operative mobilization to expedite the patient's care.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Summary
CASE REPORT Superior Gluteal Artery Perforator Flap Breast Reconstruction Salvage Following Late Venous Congestion After Discharge.
Why This Matters for Hirudotherapy
This case report describes the successful salvage of a superior gluteal artery perforator flap used for breast reconstruction after the patient returned from home with thrombosis of the venous pedicle on postoperative day five. The salvage was accomplished using a combination of mechanical and chemical thrombolysis, with no evidence of fat necrosis and a satisfactory aesthetic outcome at two-year follow-up. The abstract emphasizes the importance of patient self-examination education and hospital system readiness for late flap emergencies. The abstract makes no mention of leeches, hirudotherapy, or the leech secretome, so any relevance to the American Society of Hirudotherapy is not supported by this article's content.
Citation
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