Issue title: Selected Papers of the Joint Conference of the ESCHM-ISCH-ISB-2018, 2-6 July, 2018, Krakow, Poland
Guest editors: F. Jung and M. Fornal
Article type: Research Article
Authors: Heine-Geldern, A.a; 1 | Broer, P.N.b | Prantl, L.c | Brebant, V.c | Anker, A.M.c | Kehrer, A.c | Thiha, A.c | Lonic, D.c | Ehrl, D.d | Ninkovic, M.b | Heidekrueger, P.I.c; *
Affiliations:
[a] Department of Plastic, Hand, and Reconstructive Surgery, BG Unfallklinik, Frankfurt, Germany
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[b] Department of Plastic, Reconstructive, Hand and Burn Surgery, StKM - Klinikum Bogenhausen, Academic Teaching Hospital Technical University, Munich, Germany
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[c] Centre of Plastic, Aesthetic, Hand and Reconstructive Surgery, University of Regensburg, Regensburg, Germany
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[d] Department of Hand, Plastic, and Aesthetic Surgery, Ludwig-Maximilians University Munich, Campus Großhadern, Munich, Germany
Correspondence:
[*]
Corresponding author: Paul I. Heidekrueger, MD, Centre of Plastic, Aesthetic, Hand and Reconstructive Surgery, University of Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany. Tel.: +49 941 944 6763; Fax: +49 941 944 6948; E-mail: [email protected].
Note: [1] The first two authors have contributed equally to the preparation of the manuscript.
Abstract: BACKGROUND:While complication rates in free tissue transfers have continuously decreased over time due to improved techniques, the intraoperative use of vasopressors and their negative effects on flap microcirculation and patency of the anastomoses remains controversial. To further elucidate this matter, this retrospective study examines the effect of intraoperative vasopressors on free gracilis muscle and free fasciocutaneous anterolateral thigh (ALT) flaps for lower extremity reconstruction. METHODS:A total of 425 patients underwent 437 free flaps for lower limb reconstruction. The series was divided into two groups: use of intraoperative vasopressors (V, n = 318) or no use (NV, n = 119). The data were retrospectively screened for patients’ demographics, perioperative details, and surgical complications. RESULTS:The two groups were comparable regarding patient comorbidities. Independently of flap type, there were no significant difference between the groups regarding major complications, i.e. total flap loss (V: 5.35% versus NV: 5.04%, p = 0.899) or revision rate (V: 18.87% versus NV: 12.61%; p = 0.122), or minor complications, i.e. partial flap loss (V: 6.29% versus NV: 5.88%, p = 0.875). CONCLUSION:This study confirms that the usage of intraoperative vasopressors has no influence on free flap survival rate in lower extremity reconstruction. It seems to be no difference between free muscle or fasciocutaneous flaps.
Keywords: Vasopressors, microsurgery, free flaps, norepinephrine, lower extremity reconstruction
DOI: 10.3233/CH-189411
Journal: Clinical Hemorheology and Microcirculation, vol. 71, no. 2, pp. 193-201, 2019
