Direct Open Venous Drainage: An Alternative Choice for Flap Congestion Salvage.
10.7181/acfs.2015.16.3.143
- Author:
Su Han PARK
1
;
Woo Young CHOI
;
Kyung Min SON
;
Ji Seon CHEON
;
Jeong Yeol YANG
Author Information
1. Department of Plastic and Reconstructive Surgery, Chosun University School of Medicine, Gwangju, Korea. 8love17@hanmail.net
- Publication Type:Case Report
- Keywords:
Salvage therapy;
Leeches;
Free tissue flaps;
Heparin
- MeSH:
Arm;
Bandages;
Blood Transfusion;
Drainage*;
Estrogens, Conjugated (USP)*;
Female;
Free Tissue Flaps;
Heparin;
Humans;
Hyperemia;
Leeches;
Middle Aged;
Pressure Ulcer;
Salvage Therapy;
Scalp;
Tissue Donors;
Veins;
Wounds and Injuries
- From:Archives of Craniofacial Surgery
2015;16(3):143-146
- CountryRepublic of Korea
- Language:English
-
Abstract:
In this report, we present a scalp defect reconstruction with lateral arm free flap. We highlight the difficulty in obtaining a recipient vein and the venous drainage managed through an open end of the donor vein. A 52-year-old woman presented with a pressure sore on the left scalp. A lateral arm free flap was transferred to cover this 8x6 cm defect. The arterial anastomosis was successful, but no recipient vein could be identified within the wound bed. Instead, we used a donor venous end for the direct open venous drainage. In order to keep this exposed venous end patent, we applied heparin-soaked gauze dressing to the wound. Also, the vein end was mechanically dilated and irrigated with heparin solution at two hour intervals. Along with fluid management and blood transfusion, this management was continued for the five days after the operation. The flap survived well without any complication. Through this case, we were able to demonstrate that venous congestion can be avoided by drainage of the venous blood through an open vessel without the use of leeches.
