Serbest Doku Flebi Cerrahisinde Anestezi

Yıl 2019, Cilt: 28 Sayı: 2, 108 - 118, 30.06.2019

Murat Türkeün Ilgınel

Öz

Serbest doku transferi, pedikül flebi veya
lokal ilerleme flepleri ile kapatılamaya uygun olmayan daha büyük yumuşak doku
defektlerinin kapatılması için önemli bir tekniktir. Vasküler pedikül boyunca
kas veya fasya, üstteki cilt ile veya cilt olmadan kaldırılır ve vasküler
anastomozlar ile transfer edilir. Flep yetmezliği bu cerrahiye ait büyük bir
potansiyel komplikasyondur ve perioperatif anestezi yönetimi başarılı cerrahi
için önemli bir unsurdur. Serbest flep operasyonu için anestezinin kılavuz
ilkesi optimum kan akımının sürdürülmesidir. Ek olarak, serbest flep ameliyatı
için anestezinin hedefleri vazodilatasyon, iyi perfüzyon basıncı ve düşük
viskositedir. Bu nedenle, ağrı, hipotermi ve hipovolemi de dahil olmak üzere
vazokonstriksiyona neden olabilecek faktörlerden kaçınılmalıdır.

Anahtar Kelimeler

Anestezi, mikrosirkülasyon, rekonstrükrif cerrahi, flep

Anesthesia in Free Flap Surgery

Öz

Free tissue transfer is an important technique for closure of larger soft tissue defects that may not be amenable to pedicled or local advancement flaps. The muscle or fascia is harvested, with or without the overlying skin, along its vascular pedicle and transferred with vascular anastomosis. Flap failure is a major potential complication for this type of surgery and perioperative anaesthetic management plays an important role in successful surgery. The guiding principle of anaesthesia for free flap surgery is the maintenance of optimum blood flow. In addition, the goals of anaesthesia for free flap surgery are vasodilatation, good perfusion pressure and low viscosity. Thus, factors which may lead to vasoconstriction must be avoided, including pain, hypothermia and hypovolaemia. 

Anahtar Kelimeler

Anesthesia, free tissue flap, microcirculation, reconstructive surgery

Kaynakça

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