## Abstract Of 74 patients with extensive skin loss of the upper and lower extremities who were treated with free skin flaps, 20 patients presented with venous insufficiency within the immediate 6 to 12 hours following surgery. In 17 of these patients, the venous congestion after free tissue transf
Comparisons of medicinal leech therapy with venous catheterization in the treatment of venous congestion of the sural flap
β Scribed by Naser Mozafari; Mohammad Reza Ghazisaidi; Seyed Nejat Hosseini; Madjid Abdolzadeh
- Publisher
- John Wiley and Sons
- Year
- 2010
- Tongue
- English
- Weight
- 117 KB
- Volume
- 31
- Category
- Article
- ISSN
- 0738-1085
No coin nor oath required. For personal study only.
β¦ Synopsis
Abstract
Introduction: The originally described distally based sural flap technique has a risk of partial or total flap necrosis as high as 25%. The purpose of this study was to compare the medicinal leech therapy (MLT) with venous catheterization (VC) for blood volume removal, infection, wound dehiscence, and flap necrosis in the distally based sural flap with venous congestion. Patients and methods: Fiftyβsix conventional distally based sural flaps with venous congestion during reconstructive surgeries were randomly divided into two groups, MLT group and VC group. The results of comparisons were analyzed using SPSS software (SPSS for Windows Ver.11.5). Results: There were significant differences in terms of the average volume of removed blood (53.6cc vs.172.2cc), infection (10.7% vs. 34.6%), wound dehiscence (10.7% vs. 42.3%), flap necrosis (3.6% vs. 19.2%), and nursing (7.8 vs. 5.19) and patient's satisfaction (8.03 vs. 5.6) in the VC group and MLT group, respectively. Although local heparin irrigation was performed in the VC group, the catheter was exchanged in 10 patients due to obstruction by clot. Conclusion: It is recommended that the VC be used for congested pedicled flaps instead of leech therapy, as VC is more effective, easy, and safe in blood removal, and it has less complication. Β© 2010 WileyβLiss, Inc. Microsurgery, 2011.
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