Tran Nho V, Bishop Allen T, Convery Phyllis A, Yu Art Y
Division of Plastic Surgery, Mayo Clinic, Rochester, MN 55905, USA.
Microsurgery. 2006;26(5):370-2. doi: 10.1002/micr.20254.
Free-flap success has been the rule with technical advancements in microsurgery. Despite improvements, thrombosis and flap loss still occur occasionally. Salvaging a sick flap can be a harrowing experience, even in the most experienced hands. Thrombolysis using intravenous and intra-arterial urokinase, streptokinase, and/or tissue plasminogen activator (rtPA) administered through the flap vascular pedicle has been reported in free-flap salvages. In such situations, success depends on early diagnosis and emergent exploration. Recently, we successfully used rtPA subcutaneously to salvage a venous congested free transverse rectus abdominus myocutaneous (TRAM) flap. Here, we report on that case.
随着显微外科技术的进步，游离皮瓣移植成功率很高。尽管有所改进，但血栓形成和皮瓣丢失仍偶尔发生。挽救病变皮瓣可能是一次痛苦的经历，即使是经验最丰富的医生也不例外。在游离皮瓣挽救中，已报道通过皮瓣血管蒂静脉内和动脉内使用尿激酶、链激酶和/或组织纤溶酶原激活剂（rtPA）进行溶栓。在这种情况下，成功取决于早期诊断和紧急探查。最近，我们成功地通过皮下注射rtPA挽救了一例静脉淤血的游离腹直肌肌皮（TRAM）瓣。在此，我们报告该病例。
