J Reconstr Microsurg 1989; 5(4): 351-356
DOI: 10.1055/s-2007-1006885
ORIGINAL ARTICLE

© 1989 by Thieme Medical Publishers, Inc.

Salvage of Free Tissue Transfers Using Thrombolytic Agents

Jay A. Goldberg, William C. Pederson, William J. Barwick
  • Division of Plastic, Reconstructive, Maxillofacial and Oral Surgery, Duke University, Durham, North Carolina
Further Information

Publication History

Accepted for publication 1989

Publication Date:
08 March 2008 (online)

ABSTRACT

During the period 1985 to 1988, salvage of free tissue transfers with streptokinase and urokinase was performed in six patients with 83.3 percent success. The no-reflow phenomenon, manifested by poor intraflap flow in spite of a patent arterial anastomosis, was present in four successful patients. Streptokinase was used in four patients with 100 percent success with a dose range of 50,000 to 125,000 U. Urokinase was used in two patients with 50 percent success with a dose range of 50,000 to 100,000 U. Successful cases were reexplored within 6 hr of indication of ischemia. The unsuccessful case was reexplored 9 hr after ischemia as indicated by a laser Doppler flowmeter. Subflap hematoma occurred in one patient.

A technique is described that selectively perfuses the free flap with the thrombolytic agent and prevents systemic complications.