Anastomosis of Free Flap Pedicle to Great Vessels

BACKGROUND: Free Flaps are viable option to cover the tissue defect. Pedicle anastomosis to vessel branches has excellent result. In some situations which there is a possibility of flap failure like shortage of vessel branches, possibility of pedicle kinking or need to vein graft, anastomosis to great vessels is justified. METHODS: Six patients were allocated to study. Five cases for free jejunal flap and one case for free latissimus flap. In free jejunal flap group, pedicle anastomosis was performed as an end-side fashion to common carotid artery and internal jugular vein and in free latissimus flap, pedicle was anastomosed as an end-side fashion to superficial femoral artery and superficial femoral vein. Follow up was regular up to 20 years. RESULTS: In free jejunal flap group, there were three female and two male with age from 30 to 59 years. The sixth case was a thirteen years old male with flexion contracture of right knee who underwent free latissimus flap. Follow up was regular for 20 years. All flaps survived, and good functional result was obtained in all except one. CONCLUSION: Choosing great vessels as one side of anastomosis is safe and can be done as a primary approach due to technical demand or as a final resort when there is shortage of side branches.