Review Note
Last Update: 03/30/2025 10:50 PM
Current Deck: ACG Part 2::Plastic Surgery and Burns
New Card (Unpublished)Currently Published Content
Front
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No published tags.
Pending Suggestions
Field Change Suggestions:
Front
Commit #312117
SS_PB 1.3 Discuss the issues involved with and the anaesthetic management of patients having surgery for tissue flaps. Including:
∙ Optimising conditions for flap survival
∙ Optimising conditions for flap survival
Back
Commit #312117- Maintain MAP
- Target normal PaCO2 and acid-base status
- Target normal temperature
- Minimize use of intraoperative crystalloid that can cause interstitial oedema and venous engorgement of the flap (due to lack of lymphatics)
- Consider haemodilution with colloid to reduce Hct for optimal rheology (Hct 30-35%) and maintain urine output – Hct of 30% in theory gives the best balance between viscosity, arterial oxygen content, and tissue O2 delivery
- Minimise factors that can lead to vasospasm – pain, hypotension, pH, CO2
- Consider regional anaesthesia for peripheral limb graft sites or epidural anaesthesia where applicable
- Minimise use of vasopressors (due to theoretical risk of arterial ischemia to graft) – consider more beta agonists than alpha