Vascular complications of vascularized composite tissue transfer: outcome and salvage techniques.
Research article published in Microsurgery (1993)
Abstract
Two hundred fifty-two vascularized composite tissue transfers were performed from 1985 to 1992 at Nara Medical University Hospital. Free tissue transfers were performed in 185 patients and island tissue transfers in 67 patients. Of these, 39 flaps were reexplored because of vascular complications. On initial reexploration, vascular obstruction was found at the site of anastomosis or in the main vascular pedicle in 36 patients and in the perforating vessels to the monitor flap in three patients. Arterial thrombus occurred in 11 patients, venous thrombosis in 12, and both in nine. Twenty-five reexplored flaps were salvaged. Initially, heparin was administered systemically when vascular compromise was suspected intraoperatively or postoperatively. Recently, we have used a "continuous local heparinization" technique to minimize blood loss. This method has been used in 12 patients who underwent reexploration and in nine patients in whom vascular compromise was suspected. Nineteen flaps survived completely, and two flaps failed.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
Two hundred fifty-two vascularized composite tissue transfers were performed from 1985 to 1992 at Nara Medical University Hospital. Free tissue transfers were performed in 185 patients and island tissue transfers in 67 patients.
Por qué esto importa para la hirudoterapia
Este estudio revisó 252 transferencias de tejido compuesto vascularizado realizadas entre 1985 y 1992, documentando complicaciones vasculares en 39 colgajos reexplorados (trombo arterial en 11, trombosis venosa en 12, ambos en 9) y técnicas de rescate que incluyeron heparina sistémica y un método de 'heparinización local continua' utilizado en 21 pacientes. Si bien la terapia con sanguijuelas se emplea a veces en el rescate de colgajos por congestión venosa, este estudio no hizo ninguna mención de sanguijuelas ni de hirudoterapia —el rescate dependió por completo de la reexploración quirúrgica y la administración de heparina. Por lo tanto, la relevancia para el dominio de la ASH es insignificante, más allá del contexto clínico compartido del manejo de la trombosis vascular posquirúrgica.
Citación
Vascular complications of vascularized composite tissue transfer: outcome and salvage techniques.
Yajima et al. · Microsurgery, 1993
Contexto clínico relacionado
Explore cómo esta investigación se conecta con la práctica clínica
Añadido a la biblioteca ASH: May 28, 2026 · Última actualización del sitio: 18 de junio de 2026