Necrosis tardía en reconstrucción microvascular en cirugía oncológica de cabeza y cuello. A propósito de un caso
- Lorente Piera, Joan 1
- Fernández González, Secundino
- Díaz Zufiaurre, Natalia
- Alcalde Navarrete, Juan Manuel
- 1 Departamento de Otorrinolaringología, Clínica Universidad de Navarra, Pamplona, España.
ISSN: 0718-4816, 0716-4084
Datum der Publikation: 2024
Ausgabe: 84
Nummer: 2
Seiten: 181-186
Art: Artikel
Andere Publikationen in: Revista de Otorrinolaringología y Cirugía de Cabeza y Cuello
Zusammenfassung
Although delayed necrosis of a microvascularized free flap is not a common complication, it is important to regularly follow up with the patient and maintain meticulous hygiene in cases of total or partial maxillectomy, especially when preceded by chemotherapy and radiotherapy, as there is a higher risk of vascular pedicle exposure in the nasosinusal cavity with a fibula flap, which could lead to thrombosis due to local infection. Other causes such as venous thrombosis often emerge as the main etiology of flap failure, even though thorough care and monitoring during the first 48 hours can significantly reduce the risk of compromise. The loss of an initial flap usually necessitates salvage surgery, offering multiple options according to the reconstructive ladder to correct these defects. Substituting with a new free flap is feasible, albeit it is surgically more demanding and technically more complex.
Bibliographische Referenzen
- Cirugía oncológica de cabeza y cuello, Cirugía Reconstructiva, oncología, trombosis, quimiorradioterapia