Flow-through anastomosis for both the artery and vein in leg free flap transfer

Microsurgery ◽  
2015 ◽  
Vol 35 (7) ◽  
pp. 536-540 ◽  
Author(s):  
Masahide Fujiki ◽  
Shimpei Miyamoto ◽  
Minoru Sakuraba
Keyword(s):  
Free Flap ◽  
Flap Transfer ◽  
Free Flap Transfer ◽  
Flow Through

scholarly journals Free Flap Transfer to Preserve Main Arterial Flow in Early Reconstruction of Open Fracture in the Lower Extremity

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Mitsuru Nemoto ◽  
Shinsuke Ishikawa ◽  
Natsuko Kounoike ◽  
Takayuki Sugimoto ◽  
Akira Takeda
Keyword(s):  
Soft Tissue ◽  
Lower Extremity ◽  
Free Flap ◽  
Open Fracture ◽  
Posterior Tibial Artery ◽  
Flap Transfer ◽  
Posterior Tibial ◽  
Free Flap Transfer ◽  
Flow Through ◽  
Tissue Defects

The selection of recipient vessels is crucial when reconstructing traumatized lower extremities using a free flap. When the dorsalis pedis artery and/or posterior tibial artery cannot be palpated, we utilize computed tomography angiography to verify the site of vascular injury prior to performing free flap transfer. For vascular anastomosis, we fundamentally perform end-to-side anastomosis or flow-through anastomosis to preserve the main arterial flow. In addition, in open fracture of the lower extremity, we utilize the anterolateral thigh flap for moderate soft tissue defects and the latissimus dorsi musculocutaneous flap for extensive soft tissue defects. The free flaps used in these two techniques are long and include a large-caliber pedicle, and reconstruction can be performed with either the anterior or posterior tibial artery. The preparation of recipient vessels is easier during the acute phase early after injury, when there is no influence of scarring. A free flap allows flow-through anastomosis and is thus optimal for open fracture of the lower extremity that requires simultaneous reconstruction of main vessel injury and soft tissue defect from the middle to distal thirds of the lower extremity.

Methods of Assessing the Viability of Free Flap Transfer During the Postoperative Period

1983 ◽  
Vol 10 (1) ◽  
pp. 21-36 ◽  
Author(s):  
Douglas H. Harrison ◽  
Marjorie Girling ◽  
Godfrey Mott
Keyword(s):  
Free Flap ◽  
Postoperative Period ◽  
Flap Transfer ◽  
Free Flap Transfer

Upper Extremity Free Flap Transfers: An Analysis of the National Surgical Quality Improvement Program Database

2020 ◽  
Author(s):  
George A. Beyer ◽  
Karan Dua ◽  
Neil V. Shah ◽  
Joseph P. Scollan ◽  
Jared M. Newman ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Upper Extremity ◽  
Free Flap ◽  
Quality Improvement Program ◽  
Readmission Rates ◽  
Improvement Program ◽  
Surgical Quality ◽  
Flap Transfer ◽  
Free Flap Transfer ◽  
Reoperation Rates

Abstract Introduction We evaluated the demographics, flap types, and 30-day complication, readmission, and reoperation rates for upper extremity free flap transfers within the National Surgical Quality Improvement Program (NSQIP) database. Materials and Methods Upper extremity free flap transfer patients in the NSQIP from 2008 to 2016 were identified. Complications, reoperations, and readmissions were queried. Chi-squared tests evaluated differences in sex, race, and insurance. The types of procedures performed, complication frequencies, reoperation rates, and readmission rates were analyzed. Results One-hundred-eleven patients were selected (mean: 36.8 years). Most common upper extremity free flaps were muscle/myocutaneous (45.9%) and other vascularized bone grafts with microanastomosis (27.9%). Thirty-day complications among all patients included superficial site infections (2.7%), intraoperative transfusions (7.2%), pneumonia (0.9%), and deep venous thrombosis (0.9%). Thirty-day reoperation and readmission rates were 4.5% and 3.6%, respectively. The mean time from discharge to readmission was 12.5 days. Conclusion Upper extremity free flap transfers could be performed with a low rate of 30-day complications, reoperations, and readmissions.

Microsurgery in the Sickle Cell Trait Population: Is It Actually Safe?

2020 ◽  
pp. 1-2
Author(s):  
Michael Alperovich ◽  
Eric Park ◽  
Michael Alperovich ◽  
Omar Allam ◽  
Paul Abraham
Keyword(s):  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Free Flap ◽  
Near Infrared ◽  
Sickle Cell Trait ◽  
Cell Disease ◽  
Flap Transfer ◽  
Free Flap Transfer ◽  
Patient Reported ◽  
Deep Inferior Epigastric Perforator

Although sickle cell disease has long been viewed as a contraindication to free flap transfer, little data exist evaluating complications of microsurgical procedures in the sickle cell trait patient. Reported is the case of a 55-year-old woman with sickle cell trait who underwent a deep inferior epigastric perforator (DIEP) microvascular free flap following mastectomy. The flap developed signs of venous congestion on postoperative day two but was found to have patent arterial and venous anastomoses upon exploration in the operating room. On near-infrared indocyanine green angiography, poor vascular flow was noted despite patent anastomoses and strong cutaneous arterial Doppler signals. Intrinsic microvascular compromise or sickling remains a risk in the sickle cell trait population as it does for the sickle cell disease population. Just like in sickle cell disease patients, special care should be taken to optimize anticoagulation and minimize ischemia-induced sickling for patients with sickle cell trait undergoing microsurgery.

scholarly journals Free Flap Transfer with Arteriovenous Loop Establishment for Upper Limb Salvage in a Crush Injury

2018 ◽  
Vol 6 (11) ◽  
pp. e1913 ◽  
Author(s):  
Mohammad S. Radwan ◽  
Ammar Z. Barakat ◽  
Mohammad M. Jaber ◽  
Ashraf A. Mashal
Keyword(s):  
Limb Salvage ◽  
Upper Limb ◽  
Free Flap ◽  
Crush Injury ◽  
Flap Transfer ◽  
Free Flap Transfer ◽  
Arteriovenous Loop

Experience with epigastric free flap transfer in the rat: Technique and results

Microsurgery ◽  
1984 ◽  
Vol 5 (2) ◽  
pp. 102-104 ◽  
Author(s):  
Leonard K. Ruby ◽  
Mark Greene ◽  
Giovanni Risitand ◽  
Ricardo Torrejon ◽  
Mark R. Belsky
Keyword(s):  
Free Flap ◽  
Flap Transfer ◽  
Free Flap Transfer

Free flap transfer of the cutaneous maximus muscle in the rat: Comparison to the latissimus dorsi muscle flap

Microsurgery ◽  
1992 ◽  
Vol 13 (4) ◽  
pp. 208-213 ◽  
Author(s):  
Xiaolu Li ◽  
Brian C. Cooley ◽  
Suzann M. Gruel ◽  
Zhong Ye ◽  
John S. Gould
Keyword(s):  
Free Flap ◽  
Latissimus Dorsi ◽  
Muscle Flap ◽  
Latissimus Dorsi Muscle ◽  
Latissimus Dorsi Muscle Flap ◽  
Flap Transfer ◽  
Dorsi Muscle ◽  
Free Flap Transfer

Vascularized Free Flap Transfer in the Upper Limb

Hand Clinics ◽  
1985 ◽  
Vol 1 (2) ◽  
pp. 297-309
Author(s):  
Yoshikazu Ikuta
Keyword(s):  
Upper Limb ◽  
Free Flap ◽  
Flap Transfer ◽  
Free Flap Transfer
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