Myocutaneous versus fasciocutaneous free flap in the treatment of lower leg osteitis

1995 ◽  
Vol 5 (1) ◽  
pp. 27-31 ◽  
Author(s):  
V. Heppert ◽  
S. Becker ◽  
H. Winkler ◽  
A. Wentzensen
Keyword(s):  
Free Flap ◽  
Lower Leg

LONG-TERM DONOR-SITE MORBIDITY IN COMPOSITE ANTEROLATERAL THIGH FREE FLAP FOR COMPLEX DEFECT OF LOWER LEG AND FOOT RECONSTRUCTION

2020 ◽  
pp. 85-91
Author(s):  
Phuc Le Hong ◽  
Son Tran Thiet ◽  
Thuy Nguyen Xuan
Keyword(s):  
Soft Tissue ◽  
Skin Graft ◽  
Free Flap ◽  
Donor Site ◽  
Lower Extremities ◽  
Lower Leg ◽  
Donor Site Morbidity ◽  
Thigh Circumference ◽  
Anterolateral Thigh

Background: In recent years, the composite anterolateral thigh free flap with tensor fasciae latae or vastus lateralis has been a new-applied type of flap that can provide very good reconstruction materials in complex defects of lower leg and foot. The study purpose is to evaluate the systematically complications of donor site, related factors to results of the donor area, in order to apply the result to improve the treatment, which have not been much reported in literature. Materials and Methods: Systematic donor site morbilidy evaluation in a prospective, uncontrolled clinical descriptive study of 33 composite anterolateral thigh free flaps in various forms to reconstruct anatomical structures or to resconstruct deep defects combined with covering the surfaces for complex soft tissue defects in lower extremities for 32 patients due to different causes in lower leg and foot area from 2014-2019 at Hue University of Medicine and Pharmacy. Examining and evaluating aesthetic and functional result of donor-site 3 months and 6 months up to 2 year after surgery; evaluating the correlation between the width and the type of the flaps and donor site closure methods. Result: In 33 composite flaps used, flap width to thigh circumference less than 20% in 27 cases (81.8%), more than 20% in 6 cases (18.20% ); There were 28 cases in which the donor site was directly closed, 5 cases required skin graft; All direct closed cases had flap width/ thigh circumference index below 20%; On the contrary, in cases having this index greater than 20%, the donor site required skin graft with p < 0.01. There are 11/33 (33.33%) of cases reported complications in donor site ; lateral thigh paresthesia is the most complicated complication with 8/33 cases (24.24%), followed by bad scarring 3/33 cases (9.09%). Conclusion: Long term follow up donor site morbility after composite anterior thigh free flap present 11/33 cases (33.33%): mostly complications of the donor site are thigh paresthesia with 8/33 cases (24.24%), and bad scarring 3/33 cases (9,09%), which improve time by time. Keywords: Composite anterior thigh free flap, lower extremities soft tissue defect, donor site morbidity

Indications and Limitations of Angiography Before Free-Flap Transplantation to the Distal Lower Leg After Trauma: Prospective Study in 36 Patients

2000 ◽  
Vol Volume 16 (Number 3) ◽  
pp. 0187-0192 ◽  
Author(s):  
Barbara S. Lutz ◽  
Fu-Chan Wei ◽  
Hans-Guenther Machens ◽  
Ulrich Rhode ◽  
Alfred Berger
Keyword(s):  
Prospective Study ◽  
Free Flap ◽  
Lower Leg ◽  
Distal Lower Leg

scholarly journals Reconstruction of the Lower Leg and Foot Using the Latissimus Dorsi Free Flap Report of Four Cases

1988 ◽  
Vol 36 (4) ◽  
pp. 1445-1448
Author(s):  
Tetsumi Beppu ◽  
Takanori Imakiire ◽  
Shinya Maki ◽  
Tsuruhisa Yoshidome
Keyword(s):  
Free Flap ◽  
Latissimus Dorsi ◽  
Lower Leg

scholarly journals Cross-Leg as Salvage Procedure after Free Flaps Transfer Failure: A Case Report

2012 ◽  
Vol 2012 ◽  
pp. 1-3
Author(s):  
F. Contedini ◽  
L. Negosanti ◽  
E. Fabbri ◽  
V. Pinto ◽  
B. Tavaniello ◽  
...  
Keyword(s):  
Free Flap ◽  
Latissimus Dorsi ◽  
Free Tissue Transfer ◽  
Free Flaps ◽  
Lower Leg ◽  
Salvage Procedure ◽  
Soft Tissue Defects ◽  
Vascular Thrombosis ◽  
Flap Failure ◽  
Tissue Defects

Posttraumatic wounds of the lower leg with soft tissue defects and exposed fractures are a reconstructive challenge due to the scarce availability of local tissues and recipient vessels. Even when a free tissue transfer can be performed the risk of failure remains considerable. When a free flap is contraindicated or after a free flap failure, the cross-leg flap is still nowadays a possible option. We report a case of a male with a severe posttraumatic wound of the lower leg with exposed tibia fracture firstly treated with two consecutive latissimus dorsi muscular free flaps, failed for vascular thrombosis; the coverage was then achieved with a cross-leg flap with acceptable results.

scholarly journals Extracorporeal Perfusion for Free Fillet Lower Leg Flap After External Hemipelvectomy for Recurrent Osteosarcoma: A New Surgical Technique

2021 ◽  
Author(s):  
Lorenzo Andreani ◽  
Olimpia Mani ◽  
Edoardo Ipponi ◽  
Fabio Cosseddu ◽  
Emanuele Cigna ◽  
...  
Keyword(s):  
Free Flap ◽  
Left Kidney ◽  
Donor Site ◽  
Optimal Solution ◽  
Lower Leg ◽  
Pelvic Cavity ◽  
Ischemic Time ◽  
Oncologic Resection ◽  
Fillet Flap ◽  
Threatening Condition

Abstract BackgroundExternal hemipelvectomy often results in exposure of noble structures such as pelvic organs, joint surfaces, iliac neurovascular bundle and bone. Consequently, reconstructive surgery is always challenging. The free fillet lower leg flap is an optimal solution since it allows the transfer of a large amount of tissue and the it determines the absence of donor site morbidities. The prolonged ischemic time represents the weak point of this flap.Methods We presented the case of a 38-year-old man with recurrent radio-induced osteosarcoma arisen on pelvic cavity and involving common iliac vessels, bladder, left ureter and left kidney. We decided to use extracorporeal circulation (ECMO) in order to reduce ischemic time of the flap, since iliac vessels were necessary ligated in the middle of oncologic resection. We perfused the popliteal-based filleted lower leg musculocutaneous free flap with homologue blood and saline solution, while the oncologic dissection was completed.ResultsThe free fillet flap remained vital in the immediate postoperative period and in the following months. The patient did not come back to a life-threatening condition at 1y follow-up. ConclusionWe believed that ECMO expand the reconstructive indications in those cases in which a complex and long-lasting oncologic resection would make impossible a free flap due to prolonged ischemic time.

scholarly journals “Is dangling of the lower leg after a free flap reconstruction necessary? A study protocol for a large multicenter randomized controlled study.”

2019 ◽  
Author(s):  
David D. Krijgh ◽  
Teun Teunis ◽  
Pascal P.A. Schellekens ◽  
Marc M.A. Mureau ◽  
Antonius J.M. Luijsterburg ◽  
...  
Keyword(s):  
Free Flap ◽  
Primary Outcome ◽  
Lower Leg ◽  
Controlled Study ◽  
Postoperative Phase ◽  
Flap Reconstruction ◽  
Infection Rates ◽  
Free Flap Reconstruction ◽  
Randomized Controlled ◽  
Multicenter Randomized Controlled Trial

Abstract Background: Within the field of plastic surgery free tissue transfer is common practice for knee and lower leg defects. Usually, after such free flap reconstruction patients undergo a dangling protocol in the postoperative phase. A dangling protocol is designed to gradually subject the free flap to increased venous pressure resulting from gravitational forces. Worldwide there are multiple variations of dangling protocols. However, there is no evidence available in the literature that supports the use of a dangling protocol. Methods: This is a multicenter randomized controlled trial that includes patients with a free flap lower leg reconstruction. The primary outcome is to assess whether a no-dangling protocol is not inferior to a dangling protocol in terms of proportion of partial flap loss, six months after surgery. Secondary objectives are to identify differences in major and minor complications, length of stay, costs, and to objectify blood gaseous changes during dangling. Furthermore, at 2 years we will assess difference in physical function, infection rates and osseous union rates. Discussion: The primary outcome of this study will give a more decisive answer to the question whether a dangling protocol is necessary after a free flap reconstruction of the lower leg. The secondary outcomes of this study will provide a better insight into the physical functions, infection rates and union rates in these patients. Trial registration: Registered at the CCMO (Dutch Medical Research Ethics Commission) in the Netherlands on 11 July 2018: NL63146.041.17. Registered with the Dutch Trial Register (registration number NTR 7545).

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