Efanov Johnny Ionut, Bouhadana Gabriel, Danino Michel A
Plastic and Reconstructive Surgery Service, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, QC H2X 3E4, Canada.
Plast Reconstr Surg Glob Open. 2019 May 21;7(5):e2236. doi: 10.1097/GOX.0000000000002236. eCollection 2019 May.
Pedicled latissimus dorsi musculocutaneous flaps are reliable options for reconstruction of torso and head and neck defects. After ensuring that no kink or external compression occurs on the pedicle, the survival rate exceeds 99%. However, we experienced a complete necrosis of the flap after insertion of a peripherally inserted central catheter line. Intraoperative findings demonstrated thrombosis of the subclavian vein over a large segment, which was found to be the cause of flap failure. The clinical significance of this case report is aimed at raising awareness against insertion of peripherally inserted central catheter lines on the ipsilateral arm of a pedicled latissimus dorsi flap.
带蒂背阔肌肌皮瓣是修复躯干、头颈部缺损的可靠选择。在确保蒂部无扭结或外部压迫后,其成活率超过99%。然而,我们遇到1例在插入经外周静脉穿刺中心静脉导管后皮瓣完全坏死的病例。术中发现锁骨下静脉大片段血栓形成,这被认为是皮瓣坏死的原因。本病例报告的临床意义旨在提高对在带蒂背阔肌皮瓣同侧手臂插入经外周静脉穿刺中心静脉导管的警惕性。