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Multiple vascular anastomoses with vein grafts for salvage of congestive flaps.

The authors present two cases in which the venous drainage of transferred flaps was compromised and the flaps were salvaged by vein grafts. Traditionally, once transferred free flaps had become congestive, surgeons would re-anastomose the thrombosed veins, and administer anticoagulants or carry out peripheral vessel dilation. These authors recommend not only re-anastomosis of veins, but also additional venous drainage, with or without vein grafts.