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

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Oncologic Critical Care

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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%.

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Authors and Affiliations

  1. The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Jason Silva, Amy Jackson & Justin Broyles

Authors
  1. Jason Silva
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  2. Amy Jackson
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  3. Justin Broyles
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Corresponding author

Correspondence to Jason Silva .

Editor information

Editors and Affiliations

  1. Department of Critical Care, University of Texas MD Anderson Cancer C Department of Critical Care, Houston, TX, USA

    Joseph L. Nates

  2. Department of Critical Care, University of Texas MD Anderson Cancer C Department of Critical Care, Houston, TX, USA

    Kristen J. Price

Section Editor information

  1. Department of Anesthesiology Division of Anesthesia, Critical Care and Pain Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Garry Brydges DNP, MBA, CRNA, ACNP-BC, FAAN

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Silva, J., Jackson, A., Broyles, J. (2019). Plastic Surgery and Flap Graft Management of Radial Forearm, VRAM, and TRAM Flaps in Critically Ill Cancer Patients. In: Nates, J., Price, K. (eds) Oncologic Critical Care. Springer, Cham. https://doi.org/10.1007/978-3-319-74698-2_161-1

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  • DOI: https://doi.org/10.1007/978-3-319-74698-2_161-1

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-74698-2

  • Online ISBN: 978-3-319-74698-2

  • eBook Packages: Springer Reference MedicineReference Module Medicine

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