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Review
. 2024 Oct 18;14(5):2187-2201.
doi: 10.3390/clinpract14050172.

Novel Challenges and Opportunities for Anesthesia and Perioperative Care in Microvascular Flap Surgery: A Narrative Review

Aleksi Matias Ojuva  1   2 , Rihards Peteris Rocans  1   3 , Janis Zarins  4   5 , Evita Bine  3 , Insana Mahauri  1 , Simona Donina  6   7 , Biruta Mamaja  1 , Indulis Vanags  1
Affiliations
Review

Novel Challenges and Opportunities for Anesthesia and Perioperative Care in Microvascular Flap Surgery: A Narrative Review

Aleksi Matias Ojuva et al. Clin Pract. .

Abstract

Complex microvascular techniques and in-depth knowledge of blood rheology and microanastomosis function are required for success in microvascular flap surgery. Substantial progress has been achieved in preventing complications, but the rate of flap loss is still significant and can have significant adverse effects on the patient. Flap thrombosis, flap hematoma, and flap loss are the most frequent and severe major surgical complications. Advances in understanding the pathophysiology of different flap complications, the use of preoperative risk assessment and new treatment concepts could improve the perioperative care of microvascular flap surgery patients. Our aim was to outline novel avenues for best practice and provide an outlook for further research of anesthesia and perioperative care concepts in microvascular flap surgery.

Keywords: anesthesia; microvascular flap complications; perioperative care; reconstructive surgery.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Suggested multidisciplinary team-based approach framework for perioperative care in microvascular flap surgery.
Figure 2
Figure 2
Preoperative and intraoperative risk factors for postoperative complications in microvascular flap surgery. Abbreviations: ASA—American Society of Anesthesiologists; RBC—red blood cell.
See this image and copyright information in PMC

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