Abstract:
Interventional strategies for dealing with microvascular free flap failure are varied among institutions and even individual surgeons. This systematic review aims to identify the published methods for salvaging a failing free flap and provide surgeons with a comprehensive toolset for successful intervention. A title and abstract search of the PubMed, Embase, and Web of Science databases was performed. 1694 abstracts were screened by three reviewers according to Prisma guidelines. 62 full text articles meeting inclusion criteria detailed techniques which were separated into the categories of thrombectomy, thrombolysis, leech therapy, vascular fistula, and an \"other\" category outlining techniques which did not fit into the prior framework. Assessment of the efficacy of individual salvage techniques is limited due to limited empirical data, however, the approach to successful salvage should be based on timely identification of flap compromise, followed by the implementation of one or several of the aforementioned techniques.
摘要:
处理微血管游离皮瓣衰竭的介入策略在机构甚至个体外科医生之间是不同的。本系统综述旨在确定已发表的挽救失败的游离皮瓣的方法,并为外科医生提供成功干预的综合工具。PubMed的标题和摘要搜索,Embase,并进行了WebofScience数据库。1694份摘要由三名审稿人根据Prisma指南进行了筛选。62篇符合纳入标准的详细技术的全文文章被分为血栓切除术的类别,溶栓,水蛭治疗,血管瘘,和一个“其他”类别概述了不适合现有框架的技术。由于经验数据有限,对个人救助技术功效的评估有限,然而,成功打捞的方法应基于及时识别襟翼损坏,然后实施上述技术中的一种或几种。