Continuous high‐dose vasopressors in free anterolateral thigh flap transfer for pharyngeal reconstruction: A report of two cases |
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| Authors: | Jerry W Chao MD Erin M Taylor BA Rahmatullah W Rahmati MD Christine H Rohde MD |
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| Institution: | 1. Division of Plastic and Reconstructive Surgery, New York Presbyterian Hospital/Columbia University Medical Center, , New York, NY;2. Department of Otolaryngology—Head and Neck Surgery, New York Presbyterian Hospital/Columbia University Medical Center, , New York, NY |
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| Abstract: | Use of vasopressors is controversial in patients undergoing free flap reconstruction. Recent literature has suggested that it is safe to administer vasopressors intraoperatively during these procedures. However studies have not addressed whether this safety extends to continuous high dose use. We present two cases of patients who underwent surgery for squamous cell carcinoma of the pharyngeal region, requiring laryngopharyngectomy. Both had pharyngeal reconstruction with a free anterolateral thigh (ALT) flap. The first required intraoperative vasopressors throughout the surgery, extending into the postoperative period. The second required vasopressors in the postoperative period continuously for weeks after surgery. Vasopressors were administered at treatment levels for shock. Neither developed flap compromise, suggesting that pharyngeal reconstruction with an ALT flap may be safely performed in the setting of continuous high‐dose vasopressors. © 2013 Wiley Periodicals, Inc. Microsurgery 34:237–239, 2014. |
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