ABSTRACT
A delay in identifying incipient flap failure may inevitably lead to complete pedicle
thrombosis and the no-reflow phenomenon. The authors report a clinical case of a lateral
arm free flap that suffered complete pedicle thrombosis. They successfully salvaged
this flap, a type C fasciocutaneous “flow-through” flap, by manually moving the thrombus
from proximal to distal in the main flap artery. This freed the septofasciocutaneous
upward-perforating branches, by smoothing and applying firm pressure to the vessel,
combined with thrombolytic therapy. Their technique is offered as an alternative procedure
for salvaging a failing flow-through flap.
