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Patel SA , Abdollahi H , Ridge JA , Chang EI , Lango MN , Topham NS
Asymptomatic Deep Peroneal Vein Thrombosis During Free Fibula Flap Harvest: A Review of the Literature, Strategies for Preoperative Assessment, and an Algorithm for Reconstruction
Ann Plast Surg. 2016 Apr;76(4) :468-71
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The free fibula flap is the preferred reconstructive method for oncologic defects of the mandible. Arterial inflow of the extremity is routinely evaluated with several modalities; however, venous screening is rarely performed. Patients with cancer are at elevated risk of occult deep venous thrombosis (DVT). An asymptomatic thrombus encountered during free fibula reconstruction is a serious concern. Although such cases have been reported, we suspect the incidence of DVT during fibula free flap harvest is underappreciated. This monograph uses a case example to review risk factors for occult DVT, present a strategy for preoperative assessment, and provide a reconstructive algorithm to for mandibular reconstruction in such instances.
Patel, Sameer A Abdollahi, Hamid Ridge, John A Chang, Eric I Lango, Miriam N Topham, Neal S ENG 2014/10/03 06:00 Ann Plast Surg. 2016 Apr;76(4):468-71. doi: 10.1097/SAP.0000000000000355.