PMID: 9418917Jan 7, 1998Paper

Reversed arterial flow in free flap surgery for leg reconstruction

Annals of Plastic Surgery
C H LinW C Wu

Abstract

A lower leg open fracture with an accompanying extensive soft-tissue defect may require free flap transfer to resurface the wound. In open-leg fracture injuries the major arteries are frequently damaged during the injurious event. When the antegrade arterial blood flow is not available for arterial inflow to the free flap, end-to-side arterial anastomoses or a venous graft from a proximal healthy artery is an appropriate solution. Reversed arterial flow is another technique that may be used to provide arterial inflow to the free flap. We report 5 patients with open tibial fracture injuries that were successfully covered using latissimus dorsi muscle free flaps with reverse arterial inflow and either antegrade venous outflow (4 patients) or retrograde outflow (1 patient). This technique is indicated when (1) the defect is not located at the site adjacent to the residual antegrade artery, (2) a long vein graft might pass through severely scarred soft tissue, or (3) after failure in end-to-side anastomosis with accompanying insufficient antegrade proximal arterial flow but good distal arterial reflux.

Citations

Jun 8, 1999·Plastic and Reconstructive Surgery·S ParkT J Lee
Mar 30, 2001·Plastic and Reconstructive Surgery·O K Coşkunfirat
Aug 30, 2013·Plastic and Reconstructive Surgery·Shi-Ming FengJing-Cheng Wang
Dec 1, 2009·Journal of Maxillofacial and Oral Surgery·Stefano Spanio di SpilimbergoHung-Chi Chen
Feb 26, 2009·The Kaohsiung Journal of Medical Sciences·Shu-Hung HuangKao-Ping Chang

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