Pedicled Flaps in Association With Distal Bypass for Lower-Limb Salvage

Laurent, Bruno; Millon, Antoine; Forges, Marc Richer de; Artru, B; Lermusiaux, Patrick

doi:10.1016/j.avsg.2011.07.020

Cited by 4 publications

(3 citation statements)

References 23 publications

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“…Various types of coverage in this setting have been described, including split-thickness skin grafts, local random flaps, rotation advancement fasciocutaneous flaps, bipedicled muscle or fasciocutaneous flaps, and free tissue transfer. 11 , 12 With our previous release incisions, it was straightforward to use a local random flap with skin grafting of the donor site. These are susceptible to distal necrosis because of poor perfusion and tension but can be easily revised, as we have demonstrated.…”

Section: Discussionmentioning

confidence: 99%

Definitive coverage of distal vein graft in a case of early skin necrosis following popliteal to dorsalis pedis bypass

Taylor

Gormley

Mani

et al. 2023

Journal of Vascular Surgery Cases, Innovations and Techniques

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Section: Discussionmentioning

confidence: 99%

Definitive coverage of distal vein graft in a case of early skin necrosis following popliteal to dorsalis pedis bypass

Taylor

Gormley

Mani

et al. 2023

Journal of Vascular Surgery Cases, Innovations and Techniques

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“…24 Other studies have demonstrated extensive multiple procedures, such as revascularization combined with free or pedicled flaps, are best performed in a staged fashion given the length and complexity of the operation. [25][26][27] Yet, the literature regarding timing for less extensive procedures such as minor amputations and debridement after revascularization for CLTI is sparse.…”

Section: Discussionmentioning

confidence: 99%

Impact of the Timing of Foot Tissue Resection on Outcomes in Patients Undergoing Revascularization for Chronic Limb-Threatening Ischemia

et al. 2020

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The objective of this study is to describe utilization of revascularization and tissue resection in patients with chronic limb-threatening ischemia (CLTI) and determine whether the timing of resection impacts outcomes. Revascularizations for CLTI were queried (ACS-NSQIP 2011-2015). Outcomes included 30-day major adverse limb events (MALE), major adverse cardiac events (MACE), length of stay (LOS), operative time, 30-day readmissions, and wound infections. Groups included revascularization alone, revascularization/tissue resection during the same procedure (concurrent), or revascularization/delayed tissue resection (delayed). Resections were debridement or transmetatarsal amputations. Multivariate logistic regression determined risk-adjusted effects of tissue resection on outcomes. There was no difference in overall 30-day MACE or MALE between groups ( P = .70 and P = .35, respectively). Length of stay (6.1 days revascularization alone vs 7.8 days concurrent vs 8.7 days delayed, P < .0001) was longer in patients who underwent any tissue resection. Highest 30-day readmission and operative time was the concurrent group ( P = .02 and P < .0001, respectively). Wound infection was highest in the delayed group (1.4% revascularization alone vs 1.3% concurrent vs 6.2% delayed, P < .0001). After risk adjustment, timing of resection did not impact LOS for concurrent and delayed groups compared to revascularization alone (both P < .0001). Debridement and minor amputations can be done concurrently in patients undergoing revascularization for CLTI.

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“…Free-tissue transfer is the method of choice over staged or primary amputation. 1 Furthermore, patients with critical limb ischemia (CLI) often suffer from comorbidities, which compromise the results of these demanding operations.…”

mentioning

confidence: 99%

Inferior Limb Salvage by Combined Free-tissue Transfer and the Crane Principle Revisited

Thioné

Cavadas

2017

Plastic and Reconstructive Surgery - Global Open

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Summary:Aggressive treatment of ischemia of the lower extremities has decreased the number of amputations in both diabetic and nondiabetic patients; combined vascular reconstruction and microvascular free-flap transfer has been used to improve distal perfusion and cover large tissue defects caused by the critical limb ischemia during the past 30 years. We present our experience with a 71-year-old diabetic patient who underwent revascularization with a vascular bypass and a simultaneous microvascular flap reconstruction for limb salvage after domestic trauma. An extension of the “crane” principle was used to solve bypass exposure due to wound late complication. After 1-year follow-up, the patient was able to walk without pain. Combining 3 well-established methods of arterial revascularization and free-flap transfer and the old “crane principle,” we achieved limb salvage, offering an alternative to below-knee amputation.

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Pedicled Flaps in Association With Distal Bypass for Lower-Limb Salvage

Cited by 4 publications

References 23 publications

Definitive coverage of distal vein graft in a case of early skin necrosis following popliteal to dorsalis pedis bypass

Definitive coverage of distal vein graft in a case of early skin necrosis following popliteal to dorsalis pedis bypass

Impact of the Timing of Foot Tissue Resection on Outcomes in Patients Undergoing Revascularization for Chronic Limb-Threatening Ischemia

Inferior Limb Salvage by Combined Free-tissue Transfer and the Crane Principle Revisited

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