FLAP SALVAGE IN A FLOW-THROUGH FLAP BY MANUAL THROMBECTOMY PLUS THROMBOLYTIC THERAPY

A delay in identifying incipient flap failure may inevitably lead to c omplete pedicle thrombosis and the no-reflow phenomenon. The authors r eport a clinical case of a lateral arm free flap that suffered complet e pedicle thrombosis. They successfully salvaged this flap, a type C f asciocutaneous ''flow-through'' flap, by manually moving the thrombus from proximal to distal in the main flap artery. This freed the septof asciocutaneous upward-perforating branches, by smoothing and applying firm pressure to the vessel, combined with thrombolytic therapy. Their technique is offered as an alternative procedure for salvaging a fail ing flow-through flap.