Post-operative cardiac arrest and cardiopulmonary resuscitation did not lead to free flap necrosis or infection in an 85-year-old woman, consistent with an analysis of 5 other documented cases.
Case Report (n=6)
No
Does cardiopulmonary resuscitation affect the survival of a free flap in patients experiencing post-operative cardiac arrest?
Post-operative cardiac arrest and subsequent cardiopulmonary resuscitation may not significantly decrease the survival of free flaps.
Abstract Cardiac arrest rarely occurs during or after free flap surgery, and although multiple studies have reported the outcomes of in-hospital cardiac arrest, studies describing the outcomes of free flaps in patients who were successfully resuscitated after cardiac arrest are rare. We present herein the case of an 85-year-old woman who underwent an excisional biopsy after presenting to our dermatology department with a rapidly growing subcutaneous mass in her left forearm. A pathological examination of the biopsy specimen revealed the mass to be a malignant tumour; therefore, the patient subsequently underwent an extended excision, resulting in a 100 × 250 mm defect in the dorsum of her left forearm. The defect was successfully reconstructed using a free anterolateral thigh flap from the right leg; however, 2 days post-reconstruction, the patient experienced cardiopulmonary arrest. Spontaneous circulation was returned after 10 min of cardiopulmonary resuscitation, during which 2 mg of adrenaline was administered. The free flap was closely observed for more than 30 days post-arrest and showed no signs of necrosis or infection during that time. The patient was transferred to a nursing facility on day 53 post-arrest owing to the loss of high cognitive function. Our institution has encountered two other cases of post-operative cardiac arrest after free flap transfer in the past 8 years, and a literature search of PubMed returned three documented cases of free flap survival after cardiac arrest and resuscitation. This case report and literature review aimed to demonstrate the characteristics of the free flaps that survived cardiac arrest and subsequent resuscitation. An analysis of these six aforementioned cases of free flaps that survived cardiac arrest demonstrated that post-operative cardiac arrest and cardiopulmonary resuscitation may not significantly decrease the survival of free flaps.
Okuda et al. (Fri,) conducted a case report in Post-operative cardiac arrest after free flap surgery (n=6). Cardiopulmonary resuscitation was evaluated on Free flap survival. Post-operative cardiac arrest and cardiopulmonary resuscitation did not lead to free flap necrosis or infection in an 85-year-old woman, consistent with an analysis of 5 other documented cases.