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Wound closure by means of free flap and arteriovenous loop: Development of flap autonomy in the long‐term follow‐up
Free flaps in combination with arterial reconstruction by means of arteriovenous loops or bypass have, meanwhile, been established as a therapeutic option in defect reconstruction for areas without recipient vessels. Our aim was to analyse the long‐term performance, flap autonomy, and the flap perfu...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Blackwell Publishing Ltd
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7949459/ https://www.ncbi.nlm.nih.gov/pubmed/31668019 http://dx.doi.org/10.1111/iwj.13239 |
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author | Rother, Ulrich Müller‐Mohnssen, Helena Lang, Werner Ludolph, Ingo Arkudas, Andreas Horch, Raymund E. Regus, Susanne Meyer, Alexander |
author_facet | Rother, Ulrich Müller‐Mohnssen, Helena Lang, Werner Ludolph, Ingo Arkudas, Andreas Horch, Raymund E. Regus, Susanne Meyer, Alexander |
author_sort | Rother, Ulrich |
collection | PubMed |
description | Free flaps in combination with arterial reconstruction by means of arteriovenous loops or bypass have, meanwhile, been established as a therapeutic option in defect reconstruction for areas without recipient vessels. Our aim was to analyse the long‐term performance, flap autonomy, and the flap perfusion. Patients receiving this combined reconstruction at a single‐centre institution were included. During follow‐up examination, the patency of arterial reconstruction was investigated by duplex ultrasound. Flap micro‐circulation was assessed by laser Doppler flowmetry and white light tissue spectrometry (O2C) as well as by indocyanine green fluorescence angiography. Twenty‐three patients could be clinically followed up. Duplex ultrasound showed, in four cases, arterial pedicle occlusion in spite of vital flap. Comparison of the O2C perfusion parameters between flaps with occluded pedicles and those with intact inflow showed no significant difference (parameters sO2: P = .82; Flow: P = .31). Similar results were obtained by fluorescence angiography; no significant difference could be detected between both groups (parameters Ingress P = .13; Ingressrate P = .54). Combined vascular reconstruction with free tissue transfer is associated with a good long‐term outcome and wound closure. Even after flap transplantation to areas with critical tissue perfusion, the flap can develop autonomy and thus survive after pedicle occlusion. |
format | Online Article Text |
id | pubmed-7949459 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Blackwell Publishing Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-79494592021-07-02 Wound closure by means of free flap and arteriovenous loop: Development of flap autonomy in the long‐term follow‐up Rother, Ulrich Müller‐Mohnssen, Helena Lang, Werner Ludolph, Ingo Arkudas, Andreas Horch, Raymund E. Regus, Susanne Meyer, Alexander Int Wound J Original Articles Free flaps in combination with arterial reconstruction by means of arteriovenous loops or bypass have, meanwhile, been established as a therapeutic option in defect reconstruction for areas without recipient vessels. Our aim was to analyse the long‐term performance, flap autonomy, and the flap perfusion. Patients receiving this combined reconstruction at a single‐centre institution were included. During follow‐up examination, the patency of arterial reconstruction was investigated by duplex ultrasound. Flap micro‐circulation was assessed by laser Doppler flowmetry and white light tissue spectrometry (O2C) as well as by indocyanine green fluorescence angiography. Twenty‐three patients could be clinically followed up. Duplex ultrasound showed, in four cases, arterial pedicle occlusion in spite of vital flap. Comparison of the O2C perfusion parameters between flaps with occluded pedicles and those with intact inflow showed no significant difference (parameters sO2: P = .82; Flow: P = .31). Similar results were obtained by fluorescence angiography; no significant difference could be detected between both groups (parameters Ingress P = .13; Ingressrate P = .54). Combined vascular reconstruction with free tissue transfer is associated with a good long‐term outcome and wound closure. Even after flap transplantation to areas with critical tissue perfusion, the flap can develop autonomy and thus survive after pedicle occlusion. Blackwell Publishing Ltd 2019-10-30 /pmc/articles/PMC7949459/ /pubmed/31668019 http://dx.doi.org/10.1111/iwj.13239 Text en © 2019 The Authors. International Wound Journal published by Medicalhelplines.com Inc and John Wiley & Sons Ltd. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. |
spellingShingle | Original Articles Rother, Ulrich Müller‐Mohnssen, Helena Lang, Werner Ludolph, Ingo Arkudas, Andreas Horch, Raymund E. Regus, Susanne Meyer, Alexander Wound closure by means of free flap and arteriovenous loop: Development of flap autonomy in the long‐term follow‐up |
title | Wound closure by means of free flap and arteriovenous loop: Development of flap autonomy in the long‐term follow‐up |
title_full | Wound closure by means of free flap and arteriovenous loop: Development of flap autonomy in the long‐term follow‐up |
title_fullStr | Wound closure by means of free flap and arteriovenous loop: Development of flap autonomy in the long‐term follow‐up |
title_full_unstemmed | Wound closure by means of free flap and arteriovenous loop: Development of flap autonomy in the long‐term follow‐up |
title_short | Wound closure by means of free flap and arteriovenous loop: Development of flap autonomy in the long‐term follow‐up |
title_sort | wound closure by means of free flap and arteriovenous loop: development of flap autonomy in the long‐term follow‐up |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7949459/ https://www.ncbi.nlm.nih.gov/pubmed/31668019 http://dx.doi.org/10.1111/iwj.13239 |
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