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The Great Saphenous Vein—An Underrated Recipient Vein in Free Flap Plasty for Lower Extremity Reconstruction: A Retrospective Monocenter Study

Background  Reconstruction of large soft tissue defects of the lower extremity often requires the use of free flaps. The main limiting factor and potential for complications lie in the selection of proper donor and recipient vessels for microvascular anastomosis. While the superficial veins of the l...

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Autores principales: Meiwandi, Abdulwares, Kamper, Lars, Küenzlen, Lara, Rieger, Ulrich M., Bozkurt, Ahmet
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Thieme Medical Publishers, Inc. 2022
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9507579/
https://www.ncbi.nlm.nih.gov/pubmed/36159377
http://dx.doi.org/10.1055/s-0042-1756346
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author Meiwandi, Abdulwares
Kamper, Lars
Küenzlen, Lara
Rieger, Ulrich M.
Bozkurt, Ahmet
author_facet Meiwandi, Abdulwares
Kamper, Lars
Küenzlen, Lara
Rieger, Ulrich M.
Bozkurt, Ahmet
author_sort Meiwandi, Abdulwares
collection PubMed
description Background  Reconstruction of large soft tissue defects of the lower extremity often requires the use of free flaps. The main limiting factor and potential for complications lie in the selection of proper donor and recipient vessels for microvascular anastomosis. While the superficial veins of the lower leg are easier to dissect, they are thought to be more vulnerable to trauma and lead to a higher complication rate when using them instead of the deep accompanying veins as recipient vessels. No clear evidence exists that proves this concept. Methods  We retrospectively studied the outcomes of 97 patients who underwent free flap plasty to reconstruct predominantly traumatic defects of the lower extremity at our institute. The most used flap was the gracilis muscle flap. We divided the population into three groups based on the recipient veins that were used for microvascular anastomosis and compared their outcomes. The primary outcome was the major complication rate. Results  Overall flap survivability was 93.81%. The complication rates were not higher when using the great saphenous vein as a recipient vessel when comparing to utilizing the deep concomitant veins alone or the great saphenous vein in combination to the concomitant veins. Conclusions  In free flap surgery of the lower extremity, the selection of the recipient veins should not be restricted to the deep accompanying veins of the main vessels. The superficial veins, especially the great saphenous vein, offer an underrated option when performing free flap reconstruction.
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spelling pubmed-95075792022-09-24 The Great Saphenous Vein—An Underrated Recipient Vein in Free Flap Plasty for Lower Extremity Reconstruction: A Retrospective Monocenter Study Meiwandi, Abdulwares Kamper, Lars Küenzlen, Lara Rieger, Ulrich M. Bozkurt, Ahmet Arch Plast Surg Background  Reconstruction of large soft tissue defects of the lower extremity often requires the use of free flaps. The main limiting factor and potential for complications lie in the selection of proper donor and recipient vessels for microvascular anastomosis. While the superficial veins of the lower leg are easier to dissect, they are thought to be more vulnerable to trauma and lead to a higher complication rate when using them instead of the deep accompanying veins as recipient vessels. No clear evidence exists that proves this concept. Methods  We retrospectively studied the outcomes of 97 patients who underwent free flap plasty to reconstruct predominantly traumatic defects of the lower extremity at our institute. The most used flap was the gracilis muscle flap. We divided the population into three groups based on the recipient veins that were used for microvascular anastomosis and compared their outcomes. The primary outcome was the major complication rate. Results  Overall flap survivability was 93.81%. The complication rates were not higher when using the great saphenous vein as a recipient vessel when comparing to utilizing the deep concomitant veins alone or the great saphenous vein in combination to the concomitant veins. Conclusions  In free flap surgery of the lower extremity, the selection of the recipient veins should not be restricted to the deep accompanying veins of the main vessels. The superficial veins, especially the great saphenous vein, offer an underrated option when performing free flap reconstruction. Thieme Medical Publishers, Inc. 2022-09-23 /pmc/articles/PMC9507579/ /pubmed/36159377 http://dx.doi.org/10.1055/s-0042-1756346 Text en The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ) https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited.
spellingShingle Meiwandi, Abdulwares
Kamper, Lars
Küenzlen, Lara
Rieger, Ulrich M.
Bozkurt, Ahmet
The Great Saphenous Vein—An Underrated Recipient Vein in Free Flap Plasty for Lower Extremity Reconstruction: A Retrospective Monocenter Study
title The Great Saphenous Vein—An Underrated Recipient Vein in Free Flap Plasty for Lower Extremity Reconstruction: A Retrospective Monocenter Study
title_full The Great Saphenous Vein—An Underrated Recipient Vein in Free Flap Plasty for Lower Extremity Reconstruction: A Retrospective Monocenter Study
title_fullStr The Great Saphenous Vein—An Underrated Recipient Vein in Free Flap Plasty for Lower Extremity Reconstruction: A Retrospective Monocenter Study
title_full_unstemmed The Great Saphenous Vein—An Underrated Recipient Vein in Free Flap Plasty for Lower Extremity Reconstruction: A Retrospective Monocenter Study
title_short The Great Saphenous Vein—An Underrated Recipient Vein in Free Flap Plasty for Lower Extremity Reconstruction: A Retrospective Monocenter Study
title_sort great saphenous vein—an underrated recipient vein in free flap plasty for lower extremity reconstruction: a retrospective monocenter study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9507579/
https://www.ncbi.nlm.nih.gov/pubmed/36159377
http://dx.doi.org/10.1055/s-0042-1756346
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