Effect of intraoperative vasopressor use on free flap outcome following major head-and-neck reconstructive surgeries
Introduction: Major head-and-neck surgeries involving wide excision of the tumor usually necessitate reconstruction with free flaps for tissue cover. Even with meticulous fluid management with crystalloids, colloids, albumin, blood, and blood products, many patients become hemodynamically unstable a...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2020-01-01
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| Series: | Journal of Head & Neck Physicians and Surgeons |
| Subjects: | |
| Online Access: | http://www.jhnps.org/article.asp?issn=2347-8128;year=2020;volume=8;issue=2;spage=76;epage=79;aulast=Rajan |
| _version_ | 1819278850771648512 |
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| author | Sunil Rajan Karthik Chandra Babu Pulak Tosh |
| author_facet | Sunil Rajan Karthik Chandra Babu Pulak Tosh |
| author_sort | Sunil Rajan |
| collection | DOAJ |
| description | Introduction: Major head-and-neck surgeries involving wide excision of the tumor usually necessitate reconstruction with free flaps for tissue cover. Even with meticulous fluid management with crystalloids, colloids, albumin, blood, and blood products, many patients become hemodynamically unstable and require the use of vasopressors perioperatively. Objectives: The purpose of this analysis was to assess the safety, role, and present-day trends of the use of vasopressor agents in free flap surgeries and to find any relation of graft rejection or failure of flap surgeries or postoperative complications with perioperative use of such agents. Methods: Reviewing the literature regarding the usage of vasopressors in head-and-neck free flap surgeries, percentage of flap survival, thrombosis of the artery, venous edema, and need for revision surgery were analyzed. Most of the published data had shown that optimizing hemodynamic stability with vasopressors had a more beneficial effect on overall flap perfusion and minimized the complications of iatrogenic fluid overload. The common conclusion was that perioperative vasopressor administration was not detrimental to free flap survival. Conclusion: Based on available data, it is concluded that perioperative use of vasopressors does not adversely affect free flap outcome in patients undergoing head-and-neck reconstructive surgeries and could even be beneficial considering the avoidance of complications of liberal intravenous fluid administration. |
| first_indexed | 2024-12-24T00:18:34Z |
| format | Article |
| id | doaj.art-e1b171071306423e99fd58987e31a544 |
| institution | Directory Open Access Journal |
| issn | 2347-8128 2347-8128 |
| language | English |
| last_indexed | 2024-12-24T00:18:34Z |
| publishDate | 2020-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Head & Neck Physicians and Surgeons |
| spelling | doaj.art-e1b171071306423e99fd58987e31a5442022-12-21T17:24:39ZengWolters Kluwer Medknow PublicationsJournal of Head & Neck Physicians and Surgeons2347-81282347-81282020-01-0182767910.4103/jhnps.jhnps_53_20Effect of intraoperative vasopressor use on free flap outcome following major head-and-neck reconstructive surgeriesSunil RajanKarthik Chandra BabuPulak ToshIntroduction: Major head-and-neck surgeries involving wide excision of the tumor usually necessitate reconstruction with free flaps for tissue cover. Even with meticulous fluid management with crystalloids, colloids, albumin, blood, and blood products, many patients become hemodynamically unstable and require the use of vasopressors perioperatively. Objectives: The purpose of this analysis was to assess the safety, role, and present-day trends of the use of vasopressor agents in free flap surgeries and to find any relation of graft rejection or failure of flap surgeries or postoperative complications with perioperative use of such agents. Methods: Reviewing the literature regarding the usage of vasopressors in head-and-neck free flap surgeries, percentage of flap survival, thrombosis of the artery, venous edema, and need for revision surgery were analyzed. Most of the published data had shown that optimizing hemodynamic stability with vasopressors had a more beneficial effect on overall flap perfusion and minimized the complications of iatrogenic fluid overload. The common conclusion was that perioperative vasopressor administration was not detrimental to free flap survival. Conclusion: Based on available data, it is concluded that perioperative use of vasopressors does not adversely affect free flap outcome in patients undergoing head-and-neck reconstructive surgeries and could even be beneficial considering the avoidance of complications of liberal intravenous fluid administration.http://www.jhnps.org/article.asp?issn=2347-8128;year=2020;volume=8;issue=2;spage=76;epage=79;aulast=Rajanfree flaphead and neckperioperativereconstructionvasopressor |
| spellingShingle | Sunil Rajan Karthik Chandra Babu Pulak Tosh Effect of intraoperative vasopressor use on free flap outcome following major head-and-neck reconstructive surgeries Journal of Head & Neck Physicians and Surgeons free flap head and neck perioperative reconstruction vasopressor |
| title | Effect of intraoperative vasopressor use on free flap outcome following major head-and-neck reconstructive surgeries |
| title_full | Effect of intraoperative vasopressor use on free flap outcome following major head-and-neck reconstructive surgeries |
| title_fullStr | Effect of intraoperative vasopressor use on free flap outcome following major head-and-neck reconstructive surgeries |
| title_full_unstemmed | Effect of intraoperative vasopressor use on free flap outcome following major head-and-neck reconstructive surgeries |
| title_short | Effect of intraoperative vasopressor use on free flap outcome following major head-and-neck reconstructive surgeries |
| title_sort | effect of intraoperative vasopressor use on free flap outcome following major head and neck reconstructive surgeries |
| topic | free flap head and neck perioperative reconstruction vasopressor |
| url | http://www.jhnps.org/article.asp?issn=2347-8128;year=2020;volume=8;issue=2;spage=76;epage=79;aulast=Rajan |
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