Pedicled Free Flaps—Indications in Complex Reconstruction

Brenman, Scott A.; Barber, W. Byron; Pederson, William C.; Barwick, William J.

doi:10.1097/00000637-199001000-00022

Cited by 4 publications

(6 citation statements)

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“…Following the chimeric flap principle described by other authors [13,14] the anterolateral thigh combined with the osteocutaneous fibular flap were used, which were both chain linked to the radial artery and cephalic vein. This technique of a free flap carrier was first described by Taylor et al in 1979 and mainly used for reconstructive procedures on the trunk and the extremities, when the recipient site showed poor vascularisation [15][16][17][18][19]. In all cases, the pedicle was divided after 3-6 weeks.…”

Section: Discussionmentioning

confidence: 99%

Rapid autonomisation of a combined fibular‐ and anterolateral thigh flap transferred by a wrist carrier to an irradiated and vessel depleted neck

Wolff

Mücke

Lehmbrock

et al. 2008

Journal of Surgical Oncology

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In an irradiated and vessel depleted neck, we used the wrist carrier technique to provide flap perfusion until autonomisation took place. A combined anterolateral thigh- and osteocutaneous fibular flap was anastomosed to the radial vessels of an irradiated patient with a vessel depleted neck for reconstruction of the lower face. Periodical pedicle occlusion started immediately after surgery. On day 16, cutaneous blood flow and oxygenation were still reduced, but wound healing was uneventful.

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Section: Discussionmentioning

confidence: 99%

Rapid autonomisation of a combined fibular‐ and anterolateral thigh flap transferred by a wrist carrier to an irradiated and vessel depleted neck

Wolff

Mücke

Lehmbrock

et al. 2008

Journal of Surgical Oncology

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“…The most frequently encountered problem in the use of long vein grafts is the creation of a kink and a high risk of thrombosis. 7-10, 17 Lin et al reported a case series of 65 traumatic limb injuries reconstructed with free tissue transfers using vein grafts of significant length (>20 cm for the arterial gap). They used vein grafts for arterial defects, and a temporary arteriovenous loop in the case of both artery and vein defect.…”

Section: Discussionmentioning

confidence: 99%

“…31 It should also not be forgotten that the muscle flap and fasciocutaneous flap have different circulation patterns. 17 As skin flaps demonstrate better neovascularization due to the presence of the subdermal plexus, neovascularization is a gradual process in muscle flaps, for which reason preoperative clamping has an important role to play. Ischemic preconditioning is defined as a brief period of ischemia followed by tissue reperfusion, thereby increasing ischemic tolerance for a longer ischemic period.…”

Section: Discussionmentioning

confidence: 99%

Reconstruction of the Lower Extremity with Cross-Leg Free Flaps

Özkan

Cinpolat

Bektas

et al. 2016

J Reconstr Microsurg Open

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Background?The absence of suitable adjacent recipient vessels for microvascular anastomosis due to trauma poses a major challenge to the reconstructive surgeon. The anterior and posterior tibial vessels of the contralateral leg are the two other alternatives for use as recipient vessels for microvascular anastomosis. This method is known as the cross-leg free flap. Methods?Twenty-seven patients (20 males, 7 females) underwent cross-leg free flap operations due to absence of a suitable adjacent recipient vessel between 2007 and 2015. The mean soft tissue defect dimension was 12???11 cm (smallest: 6???7 cm; largest: 20 ?14 cm). Gustilo type 3B tibia fractures were present in 19 patients, but no fractures were present in the other 8. Six different flaps were used: 14 anterolateral thigh flaps, 6 latissimus dorsi flaps, 3 gracilis muscle flaps, 2 vastus lateralis musculocutaneous flaps, 1 tensor fascia latae flap, and 1 deep inferior epigastric perforator flap. Results?Two anterolateral thigh flaps failed, while the rest of the flaps survived completely. There were no donor-site complications. Conclusion?We think that the cross-leg free flap method can be safely and successfully used with all flap types in complex lower extremity injuries in which the adjacent recipient vessel option is unavailable.

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“…This was done since the time required for the flap to be revascularized from the wound bed is highly variable, and of course, depends on the vascularity of the recipient area [2]. Thus, in these cases division time was individualized.…”

Section: Discussion Referencesmentioning

confidence: 99%

The use of cross-leg free muscle flaps in the reconstruction of lower extremity injuries

et al. 1997

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Abstract. The cover of soft tissue and bone defects of the distal one-third of the leg resulting from crush injuries is a challenging problem. In such injuries healthy recipient vessels for free tissue transfer are frequently unavailable. Three cases of gunshot wounds and a mine explosion were managed successfully with cross-leg free muscle flaps, two latissimus dorsi and one rectus abdominis. The disadvantages of this technique are patient discomfort due to immobilization between the main and the flap division procedures together with the long hospital stay.

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Pedicled Free Flaps—Indications in Complex Reconstruction

Cited by 4 publications

References 0 publications

Rapid autonomisation of a combined fibular‐ and anterolateral thigh flap transferred by a wrist carrier to an irradiated and vessel depleted neck

Rapid autonomisation of a combined fibular‐ and anterolateral thigh flap transferred by a wrist carrier to an irradiated and vessel depleted neck

Reconstruction of the Lower Extremity with Cross-Leg Free Flaps

The use of cross-leg free muscle flaps in the reconstruction of lower extremity injuries

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