Cargando…

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

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 fr...

Descripción completa

Detalles Bibliográficos
Autores principales: Nemoto, Mitsuru, Ishikawa, Shinsuke, Kounoike, Natsuko, Sugimoto, Takayuki, Takeda, Akira
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4377480/
https://www.ncbi.nlm.nih.gov/pubmed/25861470
http://dx.doi.org/10.1155/2015/213892
_version_ 1782363919469248512
author Nemoto, Mitsuru
Ishikawa, Shinsuke
Kounoike, Natsuko
Sugimoto, Takayuki
Takeda, Akira
author_facet Nemoto, Mitsuru
Ishikawa, Shinsuke
Kounoike, Natsuko
Sugimoto, Takayuki
Takeda, Akira
author_sort Nemoto, Mitsuru
collection PubMed
description 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.
format Online
Article
Text
id pubmed-4377480
institution National Center for Biotechnology Information
language English
publishDate 2015
publisher Hindawi Publishing Corporation
record_format MEDLINE/PubMed
spelling pubmed-43774802015-04-08 Free Flap Transfer to Preserve Main Arterial Flow in Early Reconstruction of Open Fracture in the Lower Extremity Nemoto, Mitsuru Ishikawa, Shinsuke Kounoike, Natsuko Sugimoto, Takayuki Takeda, Akira Plast Surg Int Clinical Study 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. Hindawi Publishing Corporation 2015 2015-03-12 /pmc/articles/PMC4377480/ /pubmed/25861470 http://dx.doi.org/10.1155/2015/213892 Text en Copyright © 2015 Mitsuru Nemoto et al. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Study
Nemoto, Mitsuru
Ishikawa, Shinsuke
Kounoike, Natsuko
Sugimoto, Takayuki
Takeda, Akira
Free Flap Transfer to Preserve Main Arterial Flow in Early Reconstruction of Open Fracture in the Lower Extremity
title Free Flap Transfer to Preserve Main Arterial Flow in Early Reconstruction of Open Fracture in the Lower Extremity
title_full Free Flap Transfer to Preserve Main Arterial Flow in Early Reconstruction of Open Fracture in the Lower Extremity
title_fullStr Free Flap Transfer to Preserve Main Arterial Flow in Early Reconstruction of Open Fracture in the Lower Extremity
title_full_unstemmed Free Flap Transfer to Preserve Main Arterial Flow in Early Reconstruction of Open Fracture in the Lower Extremity
title_short Free Flap Transfer to Preserve Main Arterial Flow in Early Reconstruction of Open Fracture in the Lower Extremity
title_sort free flap transfer to preserve main arterial flow in early reconstruction of open fracture in the lower extremity
topic Clinical Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4377480/
https://www.ncbi.nlm.nih.gov/pubmed/25861470
http://dx.doi.org/10.1155/2015/213892
work_keys_str_mv AT nemotomitsuru freeflaptransfertopreservemainarterialflowinearlyreconstructionofopenfractureinthelowerextremity
AT ishikawashinsuke freeflaptransfertopreservemainarterialflowinearlyreconstructionofopenfractureinthelowerextremity
AT kounoikenatsuko freeflaptransfertopreservemainarterialflowinearlyreconstructionofopenfractureinthelowerextremity
AT sugimototakayuki freeflaptransfertopreservemainarterialflowinearlyreconstructionofopenfractureinthelowerextremity
AT takedaakira freeflaptransfertopreservemainarterialflowinearlyreconstructionofopenfractureinthelowerextremity