Controversies in Microvascular Maxillofacial Reconstruction

Oral Maxillofac Surg Clin North Am. 2017 Nov;29(4):415-424. doi: 10.1016/j.coms.2017.07.001.

Abstract

The effectiveness and reliability of microvascular reconstruction for large defects in the head and neck is no longer disputed. However, many controversies still persist in the ideal perioperative management of patients undergoing free tissue transfer. The optimal method of postoperative monitoring, the use of vasoconstrictors in the perioperative period, and the use of anticoagulants in the postoperative period remain topics of debate. This article offers recommendations on each of these controversies based on a review of the current literature.

Keywords: Anticoagulant; Implantable Doppler; Microvascular; Postoperative monitoring; Vasoconstrictor.

Publication types

  • Review

MeSH terms

  • Anticoagulants / administration & dosage
  • Humans
  • Microsurgery / methods*
  • Monitoring, Physiologic / methods
  • Oral Surgical Procedures / methods*
  • Plastic Surgery Procedures / methods*
  • Surgical Flaps / blood supply*
  • Vasoconstrictor Agents / administration & dosage

Substances

  • Anticoagulants
  • Vasoconstrictor Agents