Asymptomatic lower extremity deep venous thrombosis resulting in fibula free flap failure.
OBJECTIVE
The successful harvest and transplant of a fibular flap depends on many factors, including healthy inflow and outflow systems. A contraindication to harvesting a fibular flap is disease of the lower extremity arterial system; therefore, preoperative evaluation of the arterial system is routine. Preoperative evaluation of the venous system is not routine, unless there is clinical suspicion of venous disease.


METHODS
Retrospective chart review.


RESULTS
Two cases of occult deep venous thrombosis (DVT) were encountered intraoperatively resulting in nontransplantable flaps.


CONCLUSIONS
This finding represents a serious concern, and we believe that venous imaging should be considered in patients with significant risk factors for harboring an occult DVT. Laryngoscope, 2009.
Department of Otolaryngology-Head and Neck Surgery, Institute for Head, Neck, and Thyroid Cancer, Beth Israel Medical Center, New York, New York, USA. ajacobson@chpnet.org
Adam S
AS
Jacobson
Azita S
AS
Khorsandi
Daniel
D
Buchbinder
Mark L
ML
Urken
D000328:Adult; D016025:Bone Transplantation; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000175:diagnosis*; D018810:Magnetic Resonance Angiography; D008297:Male; D008338:Mandibular Injuries / Q000601:surgery*; D008437:Maxilla / Q000293:injuries*; D008545:Melanoma / Q000601:surgery*; D008875:Middle Aged; D009666:Nose / Q000293:injuries*; D010157:Palatal Neoplasms / Q000601:surgery*; D012086:Reoperation; D013406:Suicide, Attempted; D013524:Surgical Flaps / Q000098:blood supply*; D020858:Tissue and Organ Harvesting; D018608:Ultrasonography, Doppler; D020246:Venous Thrombosis / Q000175:diagnosis*; D014948:Wounds, Gunshot / Q000601:surgery*