Vasopressor-Dependent Recipient Vessel Blood Flow in Head and Neck Free Tissue Transfer: A Report of Two Cases

The utility of vasopressors in free tissue transfer continues to be a point of debate among microvascular surgeons. Surveys of microsurgeons highlight their reluctance to treat hypotension and general avoidance of vasoactive medications.[1] [2] Despite the negative attitudes toward the use of vasopressors during free flap reconstruction, multiple studies have documented a high prevalence of their use intraoperatively (52–82%), and overall lack of effect on ultimate flap outcomes.[3] [4] [5] [6] [7] [8] We report two cases of free latissimus dorsi flap reconstruction for scalp coverage, both requiring intraoperative and continuous postoperative vasopressor support to maintain adequate blood flow through the recipient artery. These cases add to the growing literature that vasopressors are safe in microsurgery, as they demonstrate vasoactive medications can be a useful tool to improve blood flow in recipient vessels in head and neck microsurgery, and not merely to maintain systemic pressures intraoperatively.

• References

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