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Direct Open Venous Drainage: An Alternative Choice for Flap Congestion Salvage

In this report, we present a scalp defect reconstruction with lateral arm free flap. We highlight the difficulty in obtaining a recipient vein and the venous drainage managed through an open end of the donor vein. A 52-year-old woman presented with a pressure sore on the left scalp. A lateral arm fr...

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Autores principales: Park, Su Han, Choi, Woo Young, Son, Kyung Min, Cheon, Ji Seon, Yang, Jeong Yeol
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Cleft Palate-Craniofacial Association 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5556784/
https://www.ncbi.nlm.nih.gov/pubmed/28913240
http://dx.doi.org/10.7181/acfs.2015.16.3.143
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author Park, Su Han
Choi, Woo Young
Son, Kyung Min
Cheon, Ji Seon
Yang, Jeong Yeol
author_facet Park, Su Han
Choi, Woo Young
Son, Kyung Min
Cheon, Ji Seon
Yang, Jeong Yeol
author_sort Park, Su Han
collection PubMed
description In this report, we present a scalp defect reconstruction with lateral arm free flap. We highlight the difficulty in obtaining a recipient vein and the venous drainage managed through an open end of the donor vein. A 52-year-old woman presented with a pressure sore on the left scalp. A lateral arm free flap was transferred to cover this 8×6 cm defect. The arterial anastomosis was successful, but no recipient vein could be identified within the wound bed. Instead, we used a donor venous end for the direct open venous drainage. In order to keep this exposed venous end patent, we applied heparin-soaked gauze dressing to the wound. Also, the vein end was mechanically dilated and irrigated with heparin solution at two hour intervals. Along with fluid management and blood transfusion, this management was continued for the five days after the operation. The flap survived well without any complication. Through this case, we were able to demonstrate that venous congestion can be avoided by drainage of the venous blood through an open vessel without the use of leeches.
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spelling pubmed-55567842017-09-14 Direct Open Venous Drainage: An Alternative Choice for Flap Congestion Salvage Park, Su Han Choi, Woo Young Son, Kyung Min Cheon, Ji Seon Yang, Jeong Yeol Arch Craniofac Surg Case Report In this report, we present a scalp defect reconstruction with lateral arm free flap. We highlight the difficulty in obtaining a recipient vein and the venous drainage managed through an open end of the donor vein. A 52-year-old woman presented with a pressure sore on the left scalp. A lateral arm free flap was transferred to cover this 8×6 cm defect. The arterial anastomosis was successful, but no recipient vein could be identified within the wound bed. Instead, we used a donor venous end for the direct open venous drainage. In order to keep this exposed venous end patent, we applied heparin-soaked gauze dressing to the wound. Also, the vein end was mechanically dilated and irrigated with heparin solution at two hour intervals. Along with fluid management and blood transfusion, this management was continued for the five days after the operation. The flap survived well without any complication. Through this case, we were able to demonstrate that venous congestion can be avoided by drainage of the venous blood through an open vessel without the use of leeches. The Korean Cleft Palate-Craniofacial Association 2015-12 2015-12-09 /pmc/articles/PMC5556784/ /pubmed/28913240 http://dx.doi.org/10.7181/acfs.2015.16.3.143 Text en © 2015 The Korean Cleft Palate-Craniofacial Association http://creativecommons.org/licenses/by-nc/3.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Park, Su Han
Choi, Woo Young
Son, Kyung Min
Cheon, Ji Seon
Yang, Jeong Yeol
Direct Open Venous Drainage: An Alternative Choice for Flap Congestion Salvage
title Direct Open Venous Drainage: An Alternative Choice for Flap Congestion Salvage
title_full Direct Open Venous Drainage: An Alternative Choice for Flap Congestion Salvage
title_fullStr Direct Open Venous Drainage: An Alternative Choice for Flap Congestion Salvage
title_full_unstemmed Direct Open Venous Drainage: An Alternative Choice for Flap Congestion Salvage
title_short Direct Open Venous Drainage: An Alternative Choice for Flap Congestion Salvage
title_sort direct open venous drainage: an alternative choice for flap congestion salvage
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5556784/
https://www.ncbi.nlm.nih.gov/pubmed/28913240
http://dx.doi.org/10.7181/acfs.2015.16.3.143
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