46 - 50 SBAs for the Final FRCA
Question 46
A 67 year old woman with COPD is scheduled for head and neck surgery for a floor of mouth malignancy.
Which of the following is an absolute contraindication to free flap formation?
- Renal failure
- History of free flap failure
- COPD
- Sickle cell disease
- Factor V Leiden
Answer
- Sickle cell disease
Sickle cell disease and uncontrolled polycythaemia rubra vera are absolute contraindications because the risk of 'microvascular sludging' and flap failure is very high.
The others are relative contraindications, apart from COPD which is not in itself a contraindication.