Microvascular free tissue transfer in reconstruction of the lower limb

Basheer, M. Haj; Wilson, Sandra; Lewis, Harry; Herbert, Kirsten

doi:10.1016/j.bjps.2007.03.029

Cited by 37 publications

(33 citation statements)

References 21 publications

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“…6 Despite improvements in microvascular instrumentation and increased experience, thrombotic difficulties are still encountered troublesome percentage of microvascular reconstructive procedures.…”

Section: Discussionmentioning

confidence: 99%

“…However, free flaps transferred to the lower limb have a higher incidence of vascular complication and flap necrosis compared to free flaps to other parts including head and neck, or upper extremity. 6 The success rates for free flap transfers to the lower limb has been reported to be ranging from 88 to 93%. [7][8][9] The reasons for these results are suggested to be due to the high incidence of trauma and associated comorbid conditions, 9 such as age-related arteriosclerosis or diabetes mellitus.…”

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confidence: 99%

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Continuous local intraarterial infusion of anticoagulants for microvascular free tissue transfer in primary reconstruction of the lower limb following resection of sarcoma

et al. 2010

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In free tissue transfers, preventing microvascular thrombosis is the first priority to achieve a successful result. Numerous protocols exist for preventing thrombosis postoperatively. We performed continuous local intraarterial infusion of anticoagulants in 11 patients undergoing wide resection of malignant soft tissue tumors, followed by primary microvascular reconstruction in the lower limb. A catheter designed for epidural anesthesia was inserted into the femoral artery and connected to a syringe pump. A daily dose of 100 ml comprising 2,000 U of heparin and 40 microg of prostaglandin E(1) was administered by means of continuous infusion for seven consecutive days as a standard regime. There were no cases of thrombosis during the continuous local intraarterial infusion of anticoagulants. There were no serious systemic complications. Although we have described limited cases and supporting data are lacking, we feel that this procedure might be useful for microsurgical reconstruction of the lower limb.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Continuous local intraarterial infusion of anticoagulants for microvascular free tissue transfer in primary reconstruction of the lower limb following resection of sarcoma

et al. 2010

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“…8 The selection of appropriate recipient vessels is an essential element for achieving successful treatment outcomes in the reconstruction of lower extremity defects using free flap. 9 The anterior tibial artery is more vulnerable to damage compared with the posterior tibial artery. It has therefore been reported that the posterior tibial artery would be more appropriate as a recipient vessel.…”

Section: Discussionmentioning

confidence: 99%

The role of microvascular tissue transfer in severe limb trauma

et al. 2017

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Background: Lower extremity reconstruction is an essential part of plastic surgery and focuses on the treatment of wounds. The restoration of an intact covering is the primary surgical requisite following trauma of the lower extremity because deep healing can be no better than the surface covering. Present study will review the field of lower extremity reconstruction focusing on the micro-vascular tissue transfer for severe limb traumatic injuries.Methods: Patients were fully evaluated and defect was assessed depending on the defect requirement free micro- vascular flap was planned. 20 micro vascular flaps in 18 males and 2 females were used for the wound / defect of lower limbs following trauma.Results: There were 18 men and 2 women with a mean age of 43.6 years (range, 18-62 years) in the present study. The overall survival of the flaps was 95% (19/20).Conclusions: The free flap is an effective method of lower-extremity reconstruction. Good outcomes can be achieved with complete debridement and the selection of appropriate recipient vessels and flaps according to the recipient site.

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“…It is well known that venous thrombosis as a cause of flap compromise is far more common than arterial thrombosis [1]. This risk is reduced by sound microsurgical technique, avoiding tension on the flap pedicle and utilising vessels of a good calibre out of the zone of injury [2]. In order to reduce the chances of flap failure early detection and surgical re-exploration is warranted [1].…”

Section: Introductionmentioning

confidence: 99%

“…In experienced microsurgical units, acceptable flap failure rates are <2 % for elective reconstructions and up to 5 % [1] following trauma. Higher failure rates are more common in trauma cases where recipient vessels for microsurgery can be damaged due to the zone of injury [2,3]. It is well known that venous thrombosis as a cause of flap compromise is far more common than arterial thrombosis [1].…”

Section: Introductionmentioning

confidence: 99%