The perfusion territory of the pedicled internal mammary artery perforator flap has been described, but the number of perforators to be included in the flap's pedicle is controversial. We studied the ...vascular territory of the dominant perforator and the contribution of additional nondominant perforators to it. Therefore, the dominant perforators in 9 fresh cadavers and the nondominant perforators in 4 of these, were injected with water-based ink. The dominant perforator vascularized a territory extending from the superior border of the clavicle to the xiphoid, and from midsternal to the anterior axial fold, with a mean craniocaudal length of 19.4 cm (range, 17.0-24.0) and a mean mediolateral width of 18.6 cm (range, 16.0-22.5). Additional injection of nondominant perforators did not lead to any substantial enlargement of this territory. One single dominant perforator vascularizes a large part of the hemithorax, allowing for various flap designs. Nondominant perforators do not have to be included in the vascular pedicle of the internal mammary artery perforator flap, which leads to less donor-site morbidity.
The treatment of drug extravasation Becker, Matthijs L; Paes, Emma C; van der Sijs, I H ...
Nederlands tijdschrift voor geneeskunde,
2011, Letnik:
155
Journal Article
An extravasation is the unintentional leakage of an intravenously-administered drug into the surrounding tissue. Extravasation can cause serious tissue injury. Risk factors for tissue injury can be ...divided in patient-related factors (age, site of extravasation, comorbidities, physical condition of the patient) and drug-related factors (mechanical injury, pharmacological properties, physicochemical properties). If the right treatment strategy (expectative policy, pharmacological or surgical intervention) is chosen at an early stage, tissue injury can largely be avoided. Comprehensive multidisciplinary approach and communication between nursing staff, the treating physician, the plastic surgeon and the hospital pharmacist is mandatory for the treatment of a patient with extravasation.
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