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J Hand Microsurg 2022; 14(02): 184-186
DOI: 10.1055/s-0040-1714449
Letter to the Editor

Use of Tissue Plasminogen Activator to Salvage a Precious Free Tissue Transfer

Gopal Malhotra
1   Department of Hand and Micro-vascular Surgery, Khoula Hospital, Muscat, Oman
,
Rahul Patil
1   Department of Hand and Micro-vascular Surgery, Khoula Hospital, Muscat, Oman
,
Venkata Nageswar Reddy Komma
1   Department of Hand and Micro-vascular Surgery, Khoula Hospital, Muscat, Oman
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Microsurgical free tissue transfer is a technically demanding exercise and requires careful planning and execution.[1] Multiple recent studies have reported success rates ranging from 95 to 98%. With meticulous pre-, intra-, and postoperative care, risk of failure can be minimized though it cannot be eliminated.[1]

The venous system being a low-pressure system is prone to stasis, subsequent thrombosis, and obstruction with minimal variation in flow dynamics or external pressure. Venous compromise is commoner than arterial obstruction among the factors leading to unfavorable outcomes following free tissue transfers.[1]

We are presenting a case of a free fibular osteo-cutaneous flap which was salvaged with an intra-arterial injection of recombinant tissue plasminogen activator (rtPA).



Publication History

Article published online:
26 July 2020

© 2020. Society of Indian Hand Surgery & Microsurgeons. All rights reserved.

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