The lateral arm free flap in lower extremity reconstruction

1997 ◽  
Vol 20 (3) ◽  
pp. 145-149 ◽  
Author(s):  
G. Merlino ◽  
M. Calcagni ◽  
F. Bergamin ◽  
D. Martin ◽  
G. Magliacani ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Free Flap ◽  
Lower Extremity Reconstruction ◽  
Extremity Reconstruction

Use of the chimeric anterolateral thigh free flap in lower extremity reconstruction

Microsurgery ◽  
2015 ◽  
Vol 35 (8) ◽  
pp. 634-639 ◽  
Author(s):  
Sang Woo Kim ◽  
Kyu Nam Kim ◽  
Joon Pio Hong ◽  
Sung Woo Park ◽  
Chae Ri Park ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Free Flap ◽  
Anterolateral Thigh ◽  
Lower Extremity Reconstruction ◽  
Extremity Reconstruction

Free Flap Lower Extremity Reconstruction in the Obese Population: Does Weight Matter?

2014 ◽  
Vol 30 (04) ◽  
pp. 263-270 ◽  
Author(s):  
Emily Cleveland ◽  
John Fischer ◽  
Jonas Nelson ◽  
Jason Wink ◽  
L. Levin ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Free Flap ◽  
Obese Population ◽  
Lower Extremity Reconstruction ◽  
Extremity Reconstruction

The Rectus Abdominis Free Flap for Lower Extremity Reconstruction

1983 ◽  
Vol 11 (5) ◽  
pp. 373-380 ◽  
Author(s):  
Juris Bunkis ◽  
Robert L. Walton ◽  
Stephen J. Mathes
Keyword(s):  
Lower Extremity ◽  
Free Flap ◽  
Rectus Abdominis ◽  
Lower Extremity Reconstruction ◽  
Extremity Reconstruction

scholarly journals Lower Extremity Reconstruction with Vascularized Free-Tissue Transfer: 20 Years of Experience in the Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand

2021 ◽  
Vol 73 (7) ◽  
pp. 462-470
Author(s):  
Nutthawut Akaranuchat
Keyword(s):  
Survival Rate ◽  
Lower Extremity ◽  
Free Flap ◽  
Free Tissue Transfer ◽  
Flap Surgery ◽  
Free Flap Surgery ◽  
Anterolateral Thigh ◽  
Lower Extremity Reconstruction ◽  
Extremity Reconstruction ◽  
The Mean

Objective: The reconstruction of extensive soft-tissue defects in the lower extremity still poses a great challenge to plastic and reconstructive surgeons. The ideal approach is to achieve a proper soft-tissue coverage with a well-vascularized flap, which results in a durable weight-bearing surface and permits normal joint motion. This study aims to retrospectively analyze the outcomes of lower-extremity reconstruction with vascularized free-tissue transfer performed at our plastic surgery division. Materials and Methods: A retrospective chart review was performed regarding 58 patients with defects in the lower extremity which were reconstructed with vascularized free-tissue transfers between 2000 and 2019. Forty-four of the patients were male, and 14 were female. The mean age was 44.4 years (range: 6-89 years). The most common indication for free-flap surgery was a secondary reconstruction after tumor eradication (23 cases, 39.7%), and 84.8% of the defects were exposed bare bones, tendons, or joints.Results: In our 58 reviewed cases, the foot was the most common area requiring reconstruction with a free flap (68.9%), and the mean defect size was 12.5 x 8.1 cm. The most commonly used free flap was the Anterolateral thigh free flap (39.7%), followed by the Gracilis free flap (29.3%), and the Superficial circumflex iliac artery-perforator free flap (10.4%). The recipient vessels most frequently used were posterior tibialis vessels (53.4%). The overall flap-survival rate was 75.9%, though there was an increased survival rate of up to 85.7% in the last five years of the period studied. The flap-salvage rate was 40.9%, and arterial thrombosis was the major cause of flap loss (50%). Factors associated with free-flap failure were re-exploration and free flap surgery after tumor or cancer eradication. The most common post-operative complication was flap-wound dehiscence (10.3%). Two patients received a flap correction due to bulkiness, and three had recurrence of ulceration. Conclusion: Microvascular free-tissue transfers for lower- extremity-defect reconstructions are reliable and valuable as a surgical technique. In over 20 years of experience in our division, we’ve had an overall flap-survival rate of 75.9%. Our flap of choice was the Anterolateral thigh free flap.

Free-Flap Lower Extremity Reconstruction: A Cohort Study and Meta-Analysis of Flap Anastomotic Outcomes between Perforator and Nonperforator Flaps

2018 ◽  
Vol 34 (06) ◽  
pp. 455-464 ◽  
Author(s):  
Christopher Song ◽  
Keith Koh ◽  
Bien-Keem Tan ◽  
Terence Goh
Keyword(s):  
Cohort Study ◽  
Lower Extremity ◽  
Free Flap ◽  
Meta Analysis ◽  
Relevant Literature ◽  
Success Rates ◽  
Perforator Flaps ◽  
Anastomotic Complications ◽  
Lower Extremity Reconstruction ◽  
Extremity Reconstruction

Introduction Free-flap outcomes in lower extremity reconstruction carry the lowest anastomotic success rates compared with other anatomical sites. Despite their advantages over traditional nonperforator flaps, free perforator flaps have only recently become established in this area due to the additional challenges faced. It is therefore crucial to assess the anastomotic outcomes of perforator and nonperforator free flaps. Methods We performed a single-center retrospective cohort study and combined this with a meta-analysis of the relevant literature. We evaluated three flap anastomotic outcomes: reexploration, operative salvage, and flap failure rates. Results Between January 2010 and June 2015, our center managed 161 patients who underwent lower extremity free-flap reconstruction, which included 76 perforator flaps and 85 nonperforator flaps. The perforator flaps had higher reexploration rates compared with the nonperforator flaps, but this was not statistically significant (18.4 and 10.6%; p = 0.18). Perforator flaps had a higher flap salvage rate but were not statistically significant (78.6 and 22.2%; p = 0.374). Lastly, although not statistically significant, perforator flaps had a lower rate of complete failure due to anastomotic complications (3.9 and 8.2%; p = 0.336). The meta-analysis included 12 studies (inclusive of the index study) and found no statistical difference in all three outcomes. Conclusion Our meta-analysis is the first reported study and serves as an indication that free perforator flaps in lower extremity are as reliable as their traditional nonperforator counterparts. This does come with the prerequisite appreciation of the anatomical variations, the delicate handling of these flaps, and a low threshold for reexploration.

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