Retrograde intra-arterial infusion of prostaglandin E1 and heparin for theno-reflow phenomenon after oromandibular reconstruction with a free fibular flap

The authors encountered a patient with a tumor of the floor of the mouth in whom the no-reflow phenomenon occurred after excision of the lesion and th e mandible, followed by reconstruction using a free fibular flap. A cathete r was inserted retrogradely from the point where the peroneal artery had be en ligated at the time of flap preparation. Continuous intra-arterial infus ion of prostaglandin El and heparin was performed, and the flap survived. T his method salvaged free flaps subject to the no-reflow phenomenon.