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Dual Venous Drainage for the Free Latissimus Dorsi Muscle Flap—Using the Serratus Vein Tributary—Making Virtue of a Necessity
Background Most flap failures in the lower limb are on account of venous congestion. Literature shows a decrease in the incidence of venous failure when two veins are anastomosed. The thoracodorsal pedicle of the latissimus dorsi free flap affords the possibility of a single venous anastomosis. The...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Thieme Medical and Scientific Publishers Pvt. Ltd.
2022
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9859684/ https://www.ncbi.nlm.nih.gov/pubmed/36683886 http://dx.doi.org/10.1055/s-0042-1759497 |
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author | Ravula, Parvati Rayidi, Venkata Koteswararao Nambi Muni, Roopesh Kumar Rangachari, Srikanth Bathini, Asha Deepthi |
author_facet | Ravula, Parvati Rayidi, Venkata Koteswararao Nambi Muni, Roopesh Kumar Rangachari, Srikanth Bathini, Asha Deepthi |
author_sort | Ravula, Parvati |
collection | PubMed |
description | Background Most flap failures in the lower limb are on account of venous congestion. Literature shows a decrease in the incidence of venous failure when two veins are anastomosed. The thoracodorsal pedicle of the latissimus dorsi free flap affords the possibility of a single venous anastomosis. The lack of a second venous outflow could result in venous congestion in the distal limits of the flap, particularly when long flaps are required for large defects or when the recipient veins are smaller in diameter. Methods We describe a consecutive series of 11 cases of latissimus dorsi flaps for leg and foot defects with a mean defect size of 310 cm (2) , where the serratus anterior vein was used as a second venous outflow channel to ensure maximal venous drainage. Results There were no re-explorations for anastomotic causes. Only one case had partial distal muscle necrosis. There was a delayed anastomotic blowout due to infection resulting in amputation in one case. There was no partial distal muscle necrosis in nine of the ten cases. Conclusion Using the serratus vein as a second venous outflow is of use in reducing incidence of venous occlusion and distal muscle necrosis and can be specially indicated for large flaps and venous diameter discrepancy. |
format | Online Article Text |
id | pubmed-9859684 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Thieme Medical and Scientific Publishers Pvt. Ltd. |
record_format | MEDLINE/PubMed |
spelling | pubmed-98596842023-01-21 Dual Venous Drainage for the Free Latissimus Dorsi Muscle Flap—Using the Serratus Vein Tributary—Making Virtue of a Necessity Ravula, Parvati Rayidi, Venkata Koteswararao Nambi Muni, Roopesh Kumar Rangachari, Srikanth Bathini, Asha Deepthi Indian J Plast Surg Background Most flap failures in the lower limb are on account of venous congestion. Literature shows a decrease in the incidence of venous failure when two veins are anastomosed. The thoracodorsal pedicle of the latissimus dorsi free flap affords the possibility of a single venous anastomosis. The lack of a second venous outflow could result in venous congestion in the distal limits of the flap, particularly when long flaps are required for large defects or when the recipient veins are smaller in diameter. Methods We describe a consecutive series of 11 cases of latissimus dorsi flaps for leg and foot defects with a mean defect size of 310 cm (2) , where the serratus anterior vein was used as a second venous outflow channel to ensure maximal venous drainage. Results There were no re-explorations for anastomotic causes. Only one case had partial distal muscle necrosis. There was a delayed anastomotic blowout due to infection resulting in amputation in one case. There was no partial distal muscle necrosis in nine of the ten cases. Conclusion Using the serratus vein as a second venous outflow is of use in reducing incidence of venous occlusion and distal muscle necrosis and can be specially indicated for large flaps and venous diameter discrepancy. Thieme Medical and Scientific Publishers Pvt. Ltd. 2022-12-22 /pmc/articles/PMC9859684/ /pubmed/36683886 http://dx.doi.org/10.1055/s-0042-1759497 Text en Association of Plastic Surgeons of India. 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 | Ravula, Parvati Rayidi, Venkata Koteswararao Nambi Muni, Roopesh Kumar Rangachari, Srikanth Bathini, Asha Deepthi Dual Venous Drainage for the Free Latissimus Dorsi Muscle Flap—Using the Serratus Vein Tributary—Making Virtue of a Necessity |
title | Dual Venous Drainage for the Free Latissimus Dorsi Muscle Flap—Using the Serratus Vein Tributary—Making Virtue of a Necessity |
title_full | Dual Venous Drainage for the Free Latissimus Dorsi Muscle Flap—Using the Serratus Vein Tributary—Making Virtue of a Necessity |
title_fullStr | Dual Venous Drainage for the Free Latissimus Dorsi Muscle Flap—Using the Serratus Vein Tributary—Making Virtue of a Necessity |
title_full_unstemmed | Dual Venous Drainage for the Free Latissimus Dorsi Muscle Flap—Using the Serratus Vein Tributary—Making Virtue of a Necessity |
title_short | Dual Venous Drainage for the Free Latissimus Dorsi Muscle Flap—Using the Serratus Vein Tributary—Making Virtue of a Necessity |
title_sort | dual venous drainage for the free latissimus dorsi muscle flap—using the serratus vein tributary—making virtue of a necessity |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9859684/ https://www.ncbi.nlm.nih.gov/pubmed/36683886 http://dx.doi.org/10.1055/s-0042-1759497 |
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