ACUTE PULMONARY-EDEMA AFTER MICROSURGERY - 2 CASE-REPORTS

Postoperative management procedures after microsurgery are well-establ ished. Usually, maintaining an adequate plasma volume will lower blood viscosity and will provide an adequate arterial inflow to keep the re plantation or the flap viable in routine microsurgical procedures. But if the patient's underlying condition is neglected, disasterous compl ications may occur. The authors report two cases with severe postopera tive complications after microsurgery. One patient was a 38-year-old m ale who suffered from diabetic foot ulcer and received a free muscle f lap transfer. He developed acute pulmonary edema at day 6 postoperativ ely. The other patient was a 20-year-old pregnant woman at 31 weeks ge station who developed pulmonary edema on the POD 4 following microsurg ical replantation of the thumb and index finger of her left hand. The complications were believed to be caused by fluid overload and neglect of the patients' underlying conditions. Knowledge of possible precipi tating factors and careful monitoring of fluid should avoid acute pulm onary edema after microsurgery under certain unusual conditions.