This paper describes the salvage of a microsurgical free flap following diffuse venous thrombosis with local Heparin and Urokinase treatment. The patient had been sent by the National Institute for the Study and Treatment of Tumors of Milan. He presented with a schwannoma affecting the intrapetrosal tract of the facial nerve and spreading to the mesocranial fossa and its excision resulted in exposure of the sinus cavernosus, the left temporal lobe and the rhinopharynx. Reconstruction was undertaken by a rectus abdominis myocutaneos flap with microsurgical anastomoses to the neck vessels. Immediately postoperatively, a diffuse venous thrombosis affected the nap and required emergency surgery to remove the venous anastomosis obstruction; however, the procedure was not a success. Salvage of the nap could only be achieved by infusion of Heparin and Urokinase in the arterial pedicle. Herein are discussed effectiveness and indications of such procedure which, in our opinion, is always worth trying, since it is easy to perform, before the flap is considered lost and before another flap is considered, as another major procedure can be quite risky.
|Translated title of the contribution||Salvage of a microsurgical free flap with local fibrinolytic and anticoagulant agents after venous thrombosis|
|Number of pages||4|
|Journal||Rivista Italiana di Chirurgia Plastica|
|Publication status||Published - 1996|
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