title: Salvage of free tissue transfers using thrombolytic agents.
abstract: During the period 1985 to 1988, salvage of free tissue transfers with streptokinase and urokinase was performed in six patients with 83.3 percent success. The no-reflow phenomenon, manifested by poor intraflap flow in spite of a patient arterial anastomosis, was present in four successful patients. Streptokinase was used in four patients with 100 percent success with a dose range of 50,000 to 125,000 U. Urokinase was used in two patients with 50 percent success with a dose range of 50,000 to 100,000 U. Successful cases were reexplored within 6 hr of indication of ischemia. The unsuccessful case was reexplored 9 hr after ischemia as indicated by a laser Doppler flowmeter. Subflap hematoma occurred in one patient. A technique is described that selectively perfuses the free flap with the thrombolytic agent and prevents systemic complications.
authors: Division of Plastic, Reconstructive, Maxillofacial and Oral Surgery, Duke University, Durham, North Carolina 22710.
authors: J A
authors: JA
authors: Goldberg
authors: W C
authors: WC
authors: Pederson
authors: W J
authors: WJ
authors: Barwick
mesh_terms: D000328:Adult; D002675:Child, Preschool; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D007511:Ischemia / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D013300:Streptokinase / Q000627:therapeutic use*; D013524:Surgical Flaps; D014568:Urokinase-Type Plasminogen Activator / Q000627:therapeutic use*; D014652:Vascular Diseases / Q000188:drug therapy*
chemical_list: D005343:Fibrinolytic Agents; D013300:Streptokinase; D014568:Urokinase-Type Plasminogen Activator