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Plastic Surgery and Flap Graft Management of Radial Forearm, VRAM, and TRAM Flaps in Critically Ill Cancer Patients

  • Jason Silva
  • Amy Jackson
  • Justin Broyles
Reference work entry

Abstract

Cancer is prevalent in society. Many oncological surgeries result in a tissue defect. Reconstructive surgery to restore the function and shape of the resected tissue is often required. The radial forearm free flap, vertical rectus abdominis myocutaneous flap, and transverse rectus abdominis myocutaneous flap are commonly used for oncological reconstruction surgery. Free flaps are particularly vulnerable to prolonged ischemia. Most flap complications to flaps occur in the first 3 day postoperatively. Monitoring of the flap is critically important. Physical assessment of the flap site should include: capillary refill, skin color, temperature, and turgor, and presence of arterial blood flow by Doppler will identify changes in tissue perfusion. Measures should be taken to ensure adequate perfusion pressure to the surgical flap. Reconstructive surgeries with free flaps have success rates of 91–99%.

Keywords

Free tissue transfer Flap checks Free flap Radial forearm VRAM TRAM Complications Postoperative Microvascular Cancer 

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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Jason Silva
    • 1
  • Amy Jackson
    • 1
  • Justin Broyles
    • 1
  1. 1.The University of Texas MD Anderson Cancer CenterHoustonUSA

Section editors and affiliations

  • Garry Brydges
    • 1
  1. 1.Department of Anesthesiology Division of Anesthesia, Critical Care and Pain MedicineThe University of Texas MD Anderson Cancer CenterHoustonUSA

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