当科における遊離組織移植術後,血流不全のため血管縫合部の再展開を要した5症例の検討

DOI
  • 太田 壮一
    京都大学大学院医学研究科感覚運動系外科学講座整形外科学
  • 柿木 良介
    京都大学大学院医学研究科感覚運動系外科学講座整形外科学
  • 藤田 俊史
    京都大学大学院医学研究科感覚運動系外科学講座整形外科学
  • 野口 貴志
    京都大学大学院医学研究科感覚運動系外科学講座整形外科学
  • 貝澤 幸俊
    京都大学大学院医学研究科感覚運動系外科学講座整形外科学

書誌事項

タイトル別名
  • Retrospective Analysis of Five Cases Requiring Revision Surgery due to Insufficient Blood Flow after Free Flap Transplantation

この論文をさがす

抄録

 We retrospectively analyzed five cases requiring revision surgery (fibula bone graft: 2, scapular cutaneous flap: 1, gracilis muscle flap: 1, latissimus dorsi musculocutaneous flap: 1) among 96 cases of free flap transfer. Twenty to 324 hours after surgery, vascular problems were recognized by color changes in the monitor flaps in four cases and a sudden decrease in surface temperature of the monitor flap in one case. Temperature-sensitive stickers were used for three cases; however, the stickers were not useful except in one case. The interval between transplantation and revision surgery ranged from 25 to 326 hours. Venous thrombectomy followed by vein grafts was performed in two cases. In one case, the anastomosis site was re-exposed and vascular patency was confirmed. In another case, although thrombectomy followed by re-anastomosis of the flap artery and anastomosis of the flap vein with a new vein in the recipient site was performed, flap necrosis occurred. In yet another case, repeat muscle transplantation was required because of partial necrosis of the transplanted muscle caused by vascular anomaly. These findings suggest that close and detailed observation of flaps, close cooperation between staff, and thorough preoperative investigation of patient risk factors for surgery as well as vascularity of grafts and recipient sites would help in increasing the success rate of surgery.

収録刊行物

詳細情報 詳細情報について

問題の指摘

ページトップへ