Salvage of a failing microvascular free muscle flap by direct continuous intravascular infusion of heparin: a case report
A free gracilis muscle transfer with skin graft was performed for reconstruction of a type IIIB lower extremity traumatic wound with acute exposure of the distal tibia fracture site and an extensive soft-tissue wound. The free muscle flap failed from a venous thrombosis that was recognized 12 hours...
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| Veröffentlicht in: | Plastic and reconstructive surgery (1963) 1989-06, Vol.83 (6), p.1045-1048 |
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| container_issue | 6 |
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| container_title | Plastic and reconstructive surgery (1963) |
| container_volume | 83 |
| creator | MAY, J. W. JR ROTHKOPF, D. M |
| description | A free gracilis muscle transfer with skin graft was performed for reconstruction of a type IIIB lower extremity traumatic wound with acute exposure of the distal tibia fracture site and an extensive soft-tissue wound. The free muscle flap failed from a venous thrombosis that was recognized 12 hours postoperatively, and reexploration revealed extensive venous thrombosis throughout the lower leg. The flap was salvaged by direct catheter administration of heparin into the vena comitans of the gracilis artery, which bathed the newly repaired venous anastomosis with an anticoagulating dose of heparin without systemic elevation of the patient's PTT. Ultimate full flap survival and wound healing ensued. |
| doi_str_mv | 10.1097/00006534-198906000-00021 |
| format | Article |
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W. JR ; ROTHKOPF, D. M</creator><creatorcontrib>MAY, J. W. JR ; ROTHKOPF, D. M</creatorcontrib><description>A free gracilis muscle transfer with skin graft was performed for reconstruction of a type IIIB lower extremity traumatic wound with acute exposure of the distal tibia fracture site and an extensive soft-tissue wound. The free muscle flap failed from a venous thrombosis that was recognized 12 hours postoperatively, and reexploration revealed extensive venous thrombosis throughout the lower leg. The flap was salvaged by direct catheter administration of heparin into the vena comitans of the gracilis artery, which bathed the newly repaired venous anastomosis with an anticoagulating dose of heparin without systemic elevation of the patient's PTT. Ultimate full flap survival and wound healing ensued.</description><identifier>ISSN: 0032-1052</identifier><identifier>EISSN: 1529-4242</identifier><identifier>DOI: 10.1097/00006534-198906000-00021</identifier><identifier>PMID: 2727151</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Adult ; Anastomosis, Surgical - adverse effects ; Biological and medical sciences ; Blood. Blood coagulation. Reticuloendothelial system ; Heparin - administration & dosage ; Humans ; Infusions, Intravenous ; Leg - blood supply ; Leg Injuries - surgery ; Male ; Medical sciences ; Multiple Trauma - surgery ; Pharmacology. 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M</creatorcontrib><title>Salvage of a failing microvascular free muscle flap by direct continuous intravascular infusion of heparin: a case report</title><title>Plastic and reconstructive surgery (1963)</title><addtitle>Plast Reconstr Surg</addtitle><description>A free gracilis muscle transfer with skin graft was performed for reconstruction of a type IIIB lower extremity traumatic wound with acute exposure of the distal tibia fracture site and an extensive soft-tissue wound. The free muscle flap failed from a venous thrombosis that was recognized 12 hours postoperatively, and reexploration revealed extensive venous thrombosis throughout the lower leg. The flap was salvaged by direct catheter administration of heparin into the vena comitans of the gracilis artery, which bathed the newly repaired venous anastomosis with an anticoagulating dose of heparin without systemic elevation of the patient's PTT. Ultimate full flap survival and wound healing ensued.</description><subject>Adult</subject><subject>Anastomosis, Surgical - adverse effects</subject><subject>Biological and medical sciences</subject><subject>Blood. Blood coagulation. Reticuloendothelial system</subject><subject>Heparin - administration & dosage</subject><subject>Humans</subject><subject>Infusions, Intravenous</subject><subject>Leg - blood supply</subject><subject>Leg Injuries - surgery</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Multiple Trauma - surgery</subject><subject>Pharmacology. Drug treatments</subject><subject>Recurrence</subject><subject>Reoperation</subject><subject>Surgical Flaps</subject><subject>Thrombophlebitis - etiology</subject><subject>Thrombophlebitis - prevention & control</subject><subject>Tibial Fractures - surgery</subject><issn>0032-1052</issn><issn>1529-4242</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1989</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo9kMFq3DAQhkVpSTdJH6GgQ-nN7Ui2LKu3EJI0EOih7dmM5VGqIsuuZAf27aNtNjswDMP8_4z0McYFfBFg9Fco0aq6qYTpDLSlq0pK8YbthJKmamQj37IdQC0rAUq-Z-c5_wUQum7VGTuTWmqhxI7tf2J4wkfis-PIHfrg4yOfvE3zE2a7BUzcJSI-bdkG4i7gwoc9H30iu3I7x9XHbd4y93FNePL46Lbs53jY-4cWTD5-KwcsZuKJljmtl-ydw5Dpw7FesN-3N7-uv1cPP-7ur68eKiu7Zq0kSaUGa6Cu5ajFANRJqbQGqYahdiWtUW5A1FZp2UDbmrGx1FqUeqQO6gv2-WXvkuZ_G-W1n3y2FAJGKu_udWeMAlBF2L0Iy99zTuT6JfkJ074X0B-o96_U-xP1_j_1Yv14vLENE40n4xFzmX86zgsfDC5htD6fZK0Rqmub-hk3lot9</recordid><startdate>19890601</startdate><enddate>19890601</enddate><creator>MAY, J. 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M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Salvage of a failing microvascular free muscle flap by direct continuous intravascular infusion of heparin: a case report</atitle><jtitle>Plastic and reconstructive surgery (1963)</jtitle><addtitle>Plast Reconstr Surg</addtitle><date>1989-06-01</date><risdate>1989</risdate><volume>83</volume><issue>6</issue><spage>1045</spage><epage>1048</epage><pages>1045-1048</pages><issn>0032-1052</issn><eissn>1529-4242</eissn><abstract>A free gracilis muscle transfer with skin graft was performed for reconstruction of a type IIIB lower extremity traumatic wound with acute exposure of the distal tibia fracture site and an extensive soft-tissue wound. The free muscle flap failed from a venous thrombosis that was recognized 12 hours postoperatively, and reexploration revealed extensive venous thrombosis throughout the lower leg. The flap was salvaged by direct catheter administration of heparin into the vena comitans of the gracilis artery, which bathed the newly repaired venous anastomosis with an anticoagulating dose of heparin without systemic elevation of the patient's PTT. Ultimate full flap survival and wound healing ensued.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>2727151</pmid><doi>10.1097/00006534-198906000-00021</doi><tpages>4</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0032-1052 |
| ispartof | Plastic and reconstructive surgery (1963), 1989-06, Vol.83 (6), p.1045-1048 |
| issn | 0032-1052 1529-4242 |
| language | eng |
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| source | MEDLINE; Journals@Ovid Complete |
| subjects | Adult Anastomosis, Surgical - adverse effects Biological and medical sciences Blood. Blood coagulation. Reticuloendothelial system Heparin - administration & dosage Humans Infusions, Intravenous Leg - blood supply Leg Injuries - surgery Male Medical sciences Multiple Trauma - surgery Pharmacology. Drug treatments Recurrence Reoperation Surgical Flaps Thrombophlebitis - etiology Thrombophlebitis - prevention & control Tibial Fractures - surgery |
| title | Salvage of a failing microvascular free muscle flap by direct continuous intravascular infusion of heparin: a case report |
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