Intraoperative Vasopressor Therapy Does Not Affect Free Flap Viability: A Myth Busted

Abstract

Introduction: The microvascular free flap is a powerful tool for tissue reconstruction developed over decades of surgical experience and outcomes. As medicine moves toward evidence based approaches to dictate therapy, the dogma that once dominated microsurgical technique is now being revisited. One such principle is the contraindication of intraoperative vasopressor therapy use. Despite multiple animal models demonstrating that systemic vasoconstriction does not lead to diminished flap oxygenation, there is scarce evidence of actual clinical data supporting the safe use of vasopressors intraoperatively. Here we evaluate the effect intraoperative vasopressors therapy use on microvascular free flap viability.