Abstract
Introduction: The majority of surgical complications after tissue transfer surgery (Localtransposition of the fasciocutaneous flap, Pedicle flap, Free flap or musculocutaneous flap) arerelated to vascular thrombosis, which usually occurs within 3 days of surgery. Venous congestionusually results in oedema and darkening of the skin colour. During early venous obstruction, aneedle stick will cause rapid bleeding of dark blood and arterial obstruction or spasm will causedelayed bleeding. Patients and methods: This is prospective study was carried out during theperiod from January 2018 to February 2021 at the Plastic surgery unit-Chirayu Medical College AndHospital Bhopal, India. This study included patients aged 13 to 70 years undergoing reconstructivesurgery with flaps (Fasciocutaneous Pedicle flap, Free flap, local transposition flap ormusculocutaneous flap) for the wounds at any part of the body. The NTG patch was applied over thecutaneous surface of the compromised flap and then flap insufficiency was observed. Results: Inthis study total of 50 patients with flaps reconstruction were included. Among which 34 %( 17patients) had skin changes and 66 % (33 patients) had congested bleed on needle prick. NTGpatches were applied on the flap surface at regular intervals. After 1 week follows up, the changes in82% (41) flaps were reversed back and the flap remained healthy. 18% (nine) flaps had partial andor complete necrosis. Conclusion: There was a marked reduction in partial flap necrosis in patientswho received nitroglycerin patch. The flap survival was significantly improved and prevents the re-exploration of flaps. Their application is a simple, safe, and effective way to help salvage the flaps.
Highlights
The majority of surgical complications after tissue transfer surgery (Local transposition of the fasciocutaneous flap, Pedicle flap, Free flap or musculocutaneous flap) are related to vascular thrombosis, which usually occurs within 3 days of surgery
There was a marked reduction in partial flap necrosis in patients who received nitroglycerin patch
This prospective observational study was carried out transfer surgery (Local transposition of the during the period from January 2018 to February fasciocutaneous flap, Pedicle flap or Free flap) are 2021 at the Chirayu Medical College And Hospital, related to vascular thrombosis, which usually occurs
Summary
The majority of surgical complications after tissue transfer surgery (Local transposition of the fasciocutaneous flap, Pedicle flap, Free flap or musculocutaneous flap) are related to vascular thrombosis, which usually occurs within 3 days of surgery. The majority of surgical complications after tissue This prospective observational study was carried out transfer surgery (Local transposition of the during the period from January 2018 to February fasciocutaneous flap, Pedicle flap or Free flap) are 2021 at the Chirayu Medical College And Hospital, related to vascular thrombosis, which usually occurs. If a flap’s vascular vascular compromise seen post-operatively we have integrity is in question, if there is a doubt of venous applied as early as possible the Nitroglycerine thrombosis at the vascular anastomosis of free patches over the ischemic or congested part of the flaps, a prompt surgical exploration is cutaneous surface of flaps for 12-14 hours daily for mandatory[1]. Surgical exploration is still one week and observe the signs of reversal and mandatory when there are hematoma and seroma salvaging of the flap
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