title: Asymptomatic Deep Peroneal Vein Thrombosis During Free Fibula Flap Harvest: A Review of the Literature, Strategies for Preoperative Assessment, and an Algorithm for Reconstruction.
abstract: The free fibula flap is the preferred reconstructive method for oncologic defects of the mandible. Arterial inflow of the extremity is routinely evaluated with several modalities; however, venous screening is rarely performed. Patients with cancer are at elevated risk of occult deep venous thrombosis (DVT). An asymptomatic thrombus encountered during free fibula reconstruction is a serious concern. Although such cases have been reported, we suspect the incidence of DVT during fibula free flap harvest is underappreciated. This monograph uses a case example to review risk factors for occult DVT, present a strategy for preoperative assessment, and provide a reconstructive algorithm to for mandibular reconstruction in such instances.
authors.affiliation: From the *Division of Plastic and Reconstructive Surgery, Department of Surgery, Fox Chase Cancer Center; †Division of Plastic and Reconstructive Surgery, Department of Surgery, Temple University Hospital; and ‡Division of Head and Neck Surgery, Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, PA.
authors.forename: Sameer A
authors.initials: SA
authors.lastname: Patel
authors.forename: Hamid
authors.initials: H
authors.lastname: Abdollahi
authors.forename: John A
authors.initials: JA
authors.lastname: Ridge
authors.forename: Eric I
authors.initials: EI
authors.lastname: Chang
authors.forename: Miriam N
authors.initials: MN
authors.lastname: Lango
authors.forename: Neal S
authors.initials: NS
authors.lastname: Topham
mesh_terms: D000368:Aged; D058070:Asymptomatic Diseases; D005260:Female; D005360:Fibula / Q000098:blood supply* / Q000637:transplantation; D058752:Free Tissue Flaps / Q000098:blood supply* / Q000637:transplantation; D006801:Humans; D007431:Intraoperative Complications / Q000175:diagnosis*; D063175:Mandibular Reconstruction / Q000379:methods*; D020246:Venous Thrombosis / Q000175:diagnosis* / Q000209:etiology