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Flap Reconstruction Complications and Mistakes
A.H. Jackson
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Everyone has a flap complication. Everyone has a flap fail. If the surgery is performed optimally, then there is less chance for complication. Technique can play a significant role in flap survival although there are numerous complications and causes.
Some common complications are: wound infection, dehiscence, vascular congestion, abscess formation, flap necrosis (complete or partial), thrombosis, hematoma, and bleeding.
Free flap transfer should culminate in a flap that fits perfectly in the defect without tension. The anastomoses should be completed between well-matching healthy vessels with good flow, with the pedicle sitting comfortably without tension, torsion, redundancy or kinking. Complications and failures are likely to occur whenever any of these steps does not go according to the plan.
The patient must be completely assessed and stabilized prior to surgery. Fortunately, tobacco, alcohol abuse and diabetes are not as big a problem as seen in human patients. Age many be a negative prognosticator, but this is not well established in dogs as in the human patient. Underlying infection or disease should be diagnosed and managed as part of the treatment plan along with any other systemic condition. [...]
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Affiliation of the authors at the time of publication
BluePearl Veterinary Partners, MINNEAPOLIS, USA.
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