Late salvage of a free TRAM flap.
We present the case of a patient with arterial thrombosis of a free TRAM flap 11 days after surgery. Initial salvage involved thrombectomy through an arteriotomy using a Fogarty catheter. Subsequent return to the operating theatre was necessary because of further vascular compromise. Thrombectomy was combined with flap thrombolysis and anticoagulation, and the flap remained viable at 6 months. Although rates of successful salvage vary, the literature indicates that flaps are rarely saved if signs of compromise present later than 2 days postoperatively. This case demonstrates that aggressive salvage may be successful even in cases of 'late' vascular compromise.
Tse
R
R
Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Western Ontario, London, Ont., Canada.
Ross
D
D
Gan
B S
BS
D000328:Adult; D001943:Breast Neoplasms / Q000601:surgery*; D018270:Carcinoma, Ductal, Breast / Q000601:surgery*; D002404:Catheterization; D005260:Female; D006801:Humans; D015411:Mastectomy, Modified Radical / Q000379:methods; D008866:Microsurgery / Q000379:methods; D011183:Postoperative Complications / Q000628:therapy*; D016879:Salvage Therapy / Q000379:methods*; D013524:Surgical Flaps; D013927:Thrombosis / Q000628:therapy*