First aid for failing flaps
Review published in J Reconstr Microsurg (2010)
Abstract
Wound coverage with pedicled (local, regional, or distant) or free flaps is commonplace throughout plastic surgery. However, irrespective of the method of tissue transfer or type of tissue being transferred, inflow and outflow remain key parameters for success. Much has been written detailing complex tissue transfers and delineating arterial and venous anatomy. Despite this, simple venous insufficiency causing venous congestion is common. In experimental models, when arterial inflow is impaired, even mild venous inadequacy affects flap survival. Furthermore, studies have shown that venous congestion is more detrimental to the rate and percentage of flap area surviving than arterial ischemia. Obviously, complete venous occlusion typically requires operative exploration and correction, but many instances occur when venous congestion occurs for reasons other than complete venous thrombosis. Here we detail the basic postoperative "first aid" techniques available to optimize venous drainage. Although these techniques are not a substitute for sound anatomic flap selection, good surgical technique, or re-operation when a significant underlying problem exists, they do offer additional options to improve flap outcomes.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
Review of basic postoperative 'first aid' techniques to optimize venous drainage and salvage failing flaps, including leech therapy among adjunct options after venous congestion not requiring reoperation.
Por qué esto importa para la hirudoterapia
This review article discusses postoperative "first aid" techniques for optimizing venous drainage in pedicled and free tissue flaps, addressing the common problem of venous congestion following tissue transfer. The authors describe adjunctive methods to improve venous outflow alongside sound surgical planning and re-exploration, though the abstract does not enumerate the specific techniques discussed. For ASH's domain, the relevance to hirudotherapy cannot be confirmed from the abstract alone, as leeching is not mentioned in the abstract text and any connection would require verification against the full article. Caveat: Based strictly on the abstract, no defensible leech link can be established; the article addresses general flap salvage methodology without specifying leech therapy involvement.
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Añadido a la biblioteca ASH: May 27, 2026 · Última actualización del sitio: June 18, 2026