Microsurgery & Lymphedema

The single most common cause of early free-flap failure in the first 48 hours is:

Best intraoperative maneuver to prevent venous kinking at the anastomosis:

Compared with hand-sewn venous anastomosis, a microvascular coupler generally:

For a buried free flap without skin paddle, the most practical monitoring option is:

Venous vs arterial compromise at the flap bedside:

A sensible default intraoperative heparin flush for microvessel lumens is:

Indication to prefer end-to-side arterial anastomosis:

Free-flap ischemia time planning—true statement:

Microsuture selection for typical 1.0–2.0 mm arterial anastomosis:

Best first-line treatment for flap pedicle vasospasm:

Routine postoperative pharmacologic protocol in many microsurgery units includes:

Two-vein strategy in free flap outflow:

During ALT flap harvest, the pedicle typically arises from:

Safe thinning principle for perforator flaps:

Reverse sural flap key pitfall:

Monitoring schedule in the first 48 h after free flap:

When using a venous coupler, the ring size is chosen to:

Primary management for early venous thrombosis detected in a free flap:

Indication for flow-through flap configuration:

Digital replantation—ischemia guidelines (general):

Replantation sequence (typical):

Venous congestion after finger replant without adequate venous outflow—temporizing measure:

Leech prophylaxis should include antibiotics active against:

ISL (International Society of Lymphology) staging—true statement:

Cornerstone of conservative lymphedema care:

Best candidates for lymphaticovenous bypass (LVB):

Donor basins with lower risk of donor-site lymphedema for VLNT:

Post-VLNT or LVB long-term management should include:

Imaging that directly maps functional superficial lymphatics intraoperatively:

Intraoperative finding most predictive of arterial thrombosis risk:

Best early indicator of venous compromise on pinprick testing:

When recipient veins are limited, which strategy improves outflow?

Supermicrosurgery is defined by anastomosis of vessels approximately:

Lymphatic pathophysiology—true statement:

After oncologic node dissection, the strongest modifiable risk factor for cellulitis flares in lymphedema is:

Omental VLNT advantages include:

Most reliable sign that an implantable Doppler arterial signal is false-positive:

Key step to reduce lymphatic donor-site morbidity in groin VLNT:

In lower-extremity free flaps with single-vessel runoff, preferred arterial anastomosis is:

Most appropriate initial management for suspected early microvascular compromise on the ward:

Routine postoperative anticoagulation after free tissue transfer should generally favor:

Why is IV dextran largely avoided in modern microsurgery?

Indication for creating an arteriovenous (AV) loop before free flap:

Best strategy when recipient arteries in the zone of injury are radiated/scarred:

Size mismatch management for arterial anastomosis (1.5–2:1 mismatch):

Arterialized venous flaps (AVFs) are most useful for:

Which free flap is at greatest risk of early venous congestion from choke-vessel limitations?

DIEP flap venous congestion intraoperatively is best treated by:

Preferred breast recipient vessels for DIEP in most settings:

When using an implantable Doppler, the sensor is best placed on the:

Tourniquet management in extremity free flaps:

First maneuver for suspected flap arterial spasm intraoperatively:

Partial distal flap necrosis management in a stable patient:

Best candidate profile for lymphaticovenous bypass (LVB):

Suction-assisted lipectomy (SAL) for lymphedema works best in:

After vascularized lymph node transfer (VLNT), patients should be counseled that:

ICG lymphography patterns indicating worsening disease include:

Distinguishing lymphedema from lipedema:

Primary lymphedema genetics—TRUE:

Contraindication to intermittent pneumatic compression in lymphedema:

Antibiotic prophylaxis for recurrent cellulitis in lymphedema:

Compression class commonly used for upper-limb maintenance after CDT:

Imaging that best quantifies lymph transport globally but with low spatial resolution:

Strategy to minimize donor-site lymphedema in inguinal VLNT:

Postoperative systemic factor most associated with flap thrombosis:

Preferred venous outflow strategy in lower-extremity free flaps:

When no suitable veins exist near the defect, the best outflow solution is:

Pathophysiology of chronic lymphedema—TRUE:

Best immediate response to a cool, pale flap with absent Doppler at 6 hours postop:

Following successful LVB, which statement is appropriate counseling?