Previous studies have demonstrated the formation of collateral vascular circulation in a transferred free flap within a specified period. Some authors advocated that the flap may survive if microvascular thrombosis occurs at the anastomosed site in a specified period. However, it is unknown how long it takes to form abundant collateral microvascular circulation.
In most previous studies, the free flap was transferred to a healthy recipient site on the animal body and the formation of collateral microvascular circulation was examined.
We performed free flap transfer for a radiation-induced ulcer on the side of the chest. Microvascular venous thrombosis in the anastomosed site developed three times in two days after first surgery. These three microvascular venous accidents were each rescued by thrombectomy. Nine days after the third thrombectomy operation, venous congestion developed again. The fourth venous thrombosis was suspected, but another thrombectomy was not performed. Although partial flap loss occurred, most of the flap survived. The ulcer healed 3 months after the first surgery.
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