Asymptomatic Deep Peroneal Vein Thrombosis During Free Fibula Flap Harvest: A Review of the Literature, Strategies for Preoperative Assessment, and an Algorithm for Reconstruction. Issue 4 (April 2016)

• Record Type: Journal Article
• Authors: Patel, Sameer A.; Abdollahi, Hamid; Ridge, John A.; Chang, Eric I.; Lango, Miriam N.; Topham, Neal S.
• Is Part Of: Annals of plastic surgery. Volume 76:Issue 4(2016:Apr.)
• Publication Date: 2016-04
• Subjects: free fibula flap -- mandibular reconstruction -- deep venous thrombus -- asymptomatic deep vein thrombosis -- peroneal vein thrombosis; Surgery, Plastic -- Periodicals; 617.95205
• DOI: 10.1097/SAP.0000000000000355
• Languages: English
• ISSNs: 0148-7043

Abstract

Abstract : Abstract: 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.