Management of flaps with compromised venous outflow in head and neck microsurgical reconstruction
Narrative review published in Microsurgery (2002)
Abstract
Microvascular tissue transfer has become an indispensable procedure for head and neck reconstruction. Although remarkable progress has been made technically, anastomosed vessel occlusion is still a serious complication. Even with technically skilled microsurgeons, anastomosed vessel occlusion occurs because the technique is not the sole prophylaxis against thrombosis in microsurgery. Therefore, to minimize the possibility of an unfavorable result in microsurgery, microsurgeons must be familiar with management options for a vascular compromised flap. Most investigators have agreed that venous obstruction occurs more often than arterial obstruction. Here, we reviewed the published literature on the salvage of venous compromised flaps from the viewpoints of surgical correction, including reanastomosis and catheter thrombectomy, and nonsurgical procedures, such as a medicinal leech, hyperbaric oxygen, and thrombolytic therapy.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Summary
Reviews surgical (reanastomosis, catheter thrombectomy) and nonsurgical (medicinal leech, hyperbaric oxygen, thrombolytics) options for venous-compromised flaps in head and neck reconstruction.
Why This Matters for Hirudotherapy
This review of the published literature surveys options for salvaging venous-compromised flaps in head and neck microsurgical reconstruction, noting that venous obstruction is more common than arterial and covering both surgical correction (reanastomosis, catheter thrombectomy) and nonsurgical measures, among them medicinal leeches, hyperbaric oxygen, and thrombolytic therapy. For ASH it places leech therapy within the recognized reconstructive-surgery toolkit for venous congestion, the indication for which hirudotherapy is most established in mainstream surgical practice. The caveat is that this is a narrative review summarizing others' reports rather than primary or comparative data, so it documents leeches as one accepted salvage option without quantifying their relative effectiveness.
Citation
Management of flaps with compromised venous outflow in head and neck microsurgical reconstruction.
Kubo T, Yano K, Hosokawa K · Microsurgery, 2002
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