通过手动血栓切除术加溶栓治疗挽救“通血”皮瓣。

Flap salvage in a "flow-through" flap by manual thrombectomy plus thrombolytic therapy.

作者信息

Wechselberger G, Schoeller T, Ohler K, Anderl H, Ninković M

机构信息

University Hospital of Plastic and Reconstructive Surgery, Leopold-Franzens University of Innsbruck, Austria.

出版信息

J Reconstr Microsurg. 1998 Feb;14(2):127-9. doi: 10.1055/s-2007-1000155.

DOI:10.1055/s-2007-1000155

PMID:9524332

Abstract

A delay in identifying incipient flap failure may inevitably lead to complete pedicle thrombosis and the no-reflow phenomenon. The authors report a clinical case of a lateral arm free flap that suffered complete pedicle thrombosis. They successfully salvaged this flap, a type C fasciocutaneous "flow-through" flap, by manually moving the thrombus from proximal to distal in the main flap artery. This freed the septofasciocutaneous upward-perforating branches, by smoothing and applying firm pressure to the vessel, combined with thrombolytic therapy. Their technique is offered as an alternative procedure for salvaging a failing flow-through flap.

摘要

识别早期皮瓣失败的延迟可能不可避免地导致完全的蒂血栓形成和无复流现象。作者报告了一例上臂外侧游离皮瓣发生完全蒂血栓形成的临床病例。他们通过手动将血栓从皮瓣主要动脉的近端向远端移动，成功挽救了这一皮瓣，即C型筋膜皮“穿流”皮瓣。通过对血管进行平滑处理并施加稳固压力，结合溶栓治疗，使隔筋膜皮向上穿支得以畅通。他们的技术为挽救失败的穿流皮瓣提供了一种替代方法。