Microsurgical Reconstruction of Lower Limb Using Thoracodorsal Artery Perforator Chimeric Free Flap after Popliteal Artery Revascularization: A Case Report

Abstract

Although traumatic popliteal artery injury is uncommon, it can significantly increase the risk of limb amputation because of the anatomical complexity and delayed diagnosis and treatment. Various tools are available for treatment. Recently, an endovascular approach has been attempted for such injuries; however, open surgical repair remains the standard treatment. An integrated and stepwise procedure involving multidisciplinary specialists, including emergency department personnel for initial evaluation, orthopedic surgeons for treating accompanying fractures or dislocations, vascular and plastic surgeons for vessel repair, and interventional radiologists for immediate diagnosis and implementation of the endovascular approach, is needed. Covering wound defects due to skin and soft tissue necrosis and irreversible ischemic damage remains difficult despite successfully revascularizing the injured vessels. Here, we describe a case of revascularization after popliteal artery injury along with successful reconstruction of a complex defect with a thoracodorsal artery perforator chimeric free flap when recipient vessel selection was limited.