Plastic Surgery and Flap Graft Management of Radial Forearm, VRAM, and TRAM Flaps in Critically Ill Cancer Patients
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%.
KeywordsFree tissue transfer Flap checks Free flap Radial forearm VRAM TRAM Complications Postoperative Microvascular Cancer
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