Eur J Plast Surg (2013) 36:211–212 DOI 10.1007/s00238-012-0744-9 LETTER TO THE EDITOR Roberto Adani & Lara Lazzaro & Luigi Tarallo Received: 30 May 2012 /Accepted: 21 June 2012 /Published online: 10 July 2012 Springer-Verlag 2012 Sir, examination revealed a sluggish capillary refill, no bleeding Survival of a great toe transfer depends on pedicle paten- from pin pricks on the tip of the reconstructed thumb and no cy immediately postoperatively, as with all microvascular Doppler signal at the microvascular anastomosis level. The free flaps. Over time, neovascularisation from the recipient patient returned to the operating room for re-exploration bed and surrounding wound margins into the graft may be which showed complete thrombosis of the vascular pedicle sufficient to maintain flap viability independent of the pri- (Fig. 1). All attempts at reanastomosis failed due to the exten- mary vascular pedicle. It is not known how long the flow in sive thrombosis throughout the vascular system of the flap. the pedicle must persist for the flap to survive and there is no The patient was hospitalized and received intravenous heparin clear consensus regarding when free flaps become com- and dextran. He was discharged 2 days later without signs of pletely independent of
European Journal of Plastic Surgery – Springer Journals
Published: Mar 1, 2013
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