Salvage of a congested DIEAP flap with subcutaneous recombinant tissue plasminogen activator treatment

Thrombolytic agents are frequently employed in the treatment of thrombosis in combination with early surgical exploration and management. Recombinant tissue plasminogen activator is a second generation thrombolytic agent, which acts specifically at the site of the haemostatic clot with minimal side effects. In this paper, we present a case with venous congestion of the deep inferior epigastric artery perforator (DIEAP) flap, despite a patent anastomosis, in which we achieved a successful outcome with subcutaneous recombinant tissue plasminogen activator treatment. (C) 2008 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.