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Flail Chest-I

Flail Chest-I

Overview of Flail Chest
Flail chest is a severe and potentially life-threatening condition characterized by the fracture of three or more adjacent ribs in multiple places. It is most commonly caused by direct impacts and trauma, such as motor vehicle accidents or injuries from a steering wheel impact. It can also occur due to falls in elderly individuals with osteoporosis, or assaults involving sharp objects.
Pathophysiology
The pathophysiology of flail chest is complex, involving fractures of...

Flail Chest-II

Flail Chest-II

Managing flail chest, a condition characterized by a segment of the chest wall moving independently from the rest of the thoracic cage, requires a comprehensive approach. It includes a thorough assessment of the patient's condition, a diagnostic evaluation to determine the extent of the injury, and the implementation of appropriate medical interventions tailored to the individual's needs.
Assessment:
1. Clinical Evaluation:
History:

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Related Experiment Video

Updated: Jun 17, 2026

A Model of Free Tissue Transfer: The Rat Epigastric Free Flap

A Model of Free Tissue Transfer: The Rat Epigastric Free Flap

Published on: January 15, 2017

Complete free flap loss due to extensive hemodilution.

Thomas Namdar¹, Tanja Bartscher, Peter L Stollwerck

¹Department of Plastic and Hand Surgery, Burn Unit, University Hospital Schleswig-Holstein Campus Lübeck, Lübeck 23538, Germany. thomas.namdar@uk-sh.de

|January 6, 2010

Summary

Extensive intraoperative fluid administration, particularly saline, during free flap surgery for lower extremity reconstruction may lead to complete flap loss. Careful fluid management is crucial for successful microsurgical outcomes.

More Related Videos

An Experimental Human DIEP Flap Model to Investigate Preservation Strategies for Vascularized Composite Allografts and Free Flaps

An Experimental Human DIEP Flap Model to Investigate Preservation Strategies for Vascularized Composite Allografts and Free Flaps

Published on: December 5, 2025

Related Experiment Videos

Last Updated: Jun 17, 2026

A Model of Free Tissue Transfer: The Rat Epigastric Free Flap

A Model of Free Tissue Transfer: The Rat Epigastric Free Flap

Published on: January 15, 2017

An Experimental Human DIEP Flap Model to Investigate Preservation Strategies for Vascularized Composite Allografts and Free Flaps

An Experimental Human DIEP Flap Model to Investigate Preservation Strategies for Vascularized Composite Allografts and Free Flaps

Published on: December 5, 2025

Area of Science:

Microsurgery
Plastic Surgery
Reconstructive Surgery

Background:

Free tissue transfer is a standard technique for lower extremity wound reconstruction.
The optimal intravenous fluid strategy during microsurgery remains debated.
Hemodilution effects on hemostasis during microsurgery require further investigation.

Purpose of the Study:

To evaluate the impact of intraoperative fluid management on free latissimus dorsi muscle flap survival in lower extremity reconstruction.

Main Methods:

Retrospective analysis of 48 patients undergoing free latissimus dorsi muscle flap for posttraumatic lower leg soft-tissue coverage.
Intraoperative infusion management was assessed.
Postoperative flap perfusion was monitored clinically.

Main Results:

Complete loss of the free latissimus dorsi muscle flap occurred in 4 out of 48 patients.
Patients experiencing flap loss received significantly higher volumes of saline infusion (6,125 ml vs. 4,534 ml).
Higher total infusion volumes relative to body weight were also associated with flap loss (69 ml/kg vs. 44 ml/kg).

Conclusions:

Extensive intraoperative hyperhydration, particularly with saline, is clinically relevant and can result in complete free flap loss.
This finding highlights the importance of judicious fluid management in microsurgical reconstruction.
Avoiding excessive fluid administration may improve free flap survival rates.