Yıl: 2022 Cilt: 28 Sayı: 12 Sayfa Aralığı: 1701 - 1707 Metin Dili: İngilizce DOI: 10.14744/tjtes.2022.97970 İndeks Tarihi: 24-05-2023

An idea for bringing the recipient pedicle of cross leg free flap closer: Fasciocutaneous flap above pedicle

Öz:
BACKGROUND: Cross leg free flaps are one of the salvage methods used for free tissue transfer in large tissue defects in the ab- sence of recipient vessels. The fasciocutaneous flap above the posterior tibial artery can be harvested to protect the pedicle and to advance a distance to wound, which is equal to the length of fasciocutaneous flap. METHODS: Patients who were operated with cross leg free flap with the supporting fasciocutaneous flap on unwounded side were included in the study between years 2010 and 2020. Age, sex, location and size of the defects, arterial patencies, flap choices, fascio- cutaneous flap size, duration of operation, cross flap separation timing, complications, and time to return to work were evaluated. RESULTS: There were six patients with the etiology of high-energy electrical burns and trauma. There was only one arterial refilling for three patients and no refilling for others. Latissimus dorsi skin muscle flap was used in all but one patient. The mean defect size was 6.6×14.8 cm. The mean size of fasciocutaneous flaps was 4.08×5 cm. The mean operation time was 360 min. There was no com- plication except one dehiscence and one marginal necrosis and infection which were healed with wound care. Average time to return to work was 9 months. CONCLUSION: In similar cases, as wounded lower extremities with one or no artery refill, harvesting a fasciocutaneous flap with recipient vessels will be useful before considering the option of using a bridge free flap in medium to moderate sized defects.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Bradley L, Kirker SG. Secondary prevention of arteriosclerosis in lower limb vascular amputees: A missed opportunity. Eur J Vasc Endovasc Surg 2006;32:491–3.
  • 2. Bosse MJ, MacKenzie EJ, Kellam JF, Burgess AR, Webb LX, Swion- tkowski MF, et al. An analysis of outcomes of reconstruction or amputa- tion after leg-threatening ınjuries. N Engl J Med 2002;347:1924–31.
  • 3. MacKenzie EJ, Bosse MJ, Pollak AN, Webb LX, Swiontkowski MF, Kel- lam JF, et al. Long-term persistence of disability following severe lower- limb trauma: Results of a seven-year follow-up. J Bone Joint Surg Am 2005;87:1801–9.
  • 4. Bhuvaneswar CG, Epstein LA, Stern TA. Reactions to amputation: Recognition and treatment. Prim Care Companion J Clin Psychiatry 2007;9:303–8.
  • 5. Manrique OJ, Bishop SN, Ciudad P, Adabi K, Martinez-Jorge J, Moran SL, et al. Lower extremity limb salvage with cross leg pedicle flap, cross leg free flap, and cross leg vascular cable bridge flap. J Reconstr Microsurg 2018;34:522–9.
  • 6. Howe HR Jr., Poole GV Jr., Hansen KJ, Clark T, Plonk GW, Koman LA, et al. Salvage of lower extremities following combined orthopedic and vascular trauma. A predictive salvage index. Am Surg 1987;53:205–8.
  • 7. Russell WL, Sailors DM, Whittle TB, Fisher DF Jr., Burns RP. Limb salvage versus traumatic amputation: A decision based on a seven-part predictive index. Ann Surg 1991;213:473–80; discussion 480–1.
  • 8. McNamara MG, Heckman JD, Corley FG. Severe open fractures of the lower extremity: A retrospective evaluation of the mangled extremity severity score (mess). J Orthop Trauma 1994;8:81–7.
  • 9. MacKenzie EJ, Jones AS, Bosse MJ, Castillo RC, Pollak AN, Webb LX, et al. Health-care costs associated with amputation or reconstruction of a limb-threatening injury. J Bone Joint Surg Am 2007;89:1685–92.
  • 10. Komorowska-Timek E, Gurtner G, Lee GK. Supercharged reverse pedi- cle anterolateral thigh flap in reconstruction of a massive defect: A case report. Microsurgery 2010;30:397–400.
  • 11. Cavadas PC. Arteriovenous vascular loops in free flap reconstruction of the extremities. Plast Reconstr Surg 2008;121:514–20.
  • 12. Oswald TM, Stover SA, Gerzenstein J, Lei MP, Zhang F, Muskett A, et al. Immediate and delayed use of arteriovenous fistulae in microsurgical flap procedures: A clinical series and review of published cases. Ann Plast Surg 2007;58:61–3.
  • 13. Topalan M, Ermis I. Cross-leg free flap for emergency extremity salvage: Case report. J Reconstr Microsurg 2001;17:157–61.
  • 14. Van Boerum MS, Wright T, McFarland M, Fiander M, Pannucci CJ. Cross-leg flaps for lower extremity salvage: A scoping review. J Reconstr Microsurg 2019;35:505–15.
  • 15. Eser C. An alternative method to free flap for distal leg and foot defects due to electrical burn injury: Distally based cross-leg sural flap. Turkish J Trauma Emerg Surg 2016;22:46–51.
  • 16. Lu J, Chavanon V, Margulies I, Yao AS. Cross-leg latissimus dorsi free flap with chimeric serratus anterior bridge for lower extremity trauma: Case report and reconstructive algorithm. J Clin Orthop Trauma 2019;10:867–72.
  • 17. Yu ZJ, Zeng BF, Huang YC, He HG, Sui SP, Jiang PZ, et al. Applica- tion of the cross-bridge microvascular anastomosis when no recipient vessels are available for anastomosis: 85 Cases. Plast Reconstr Surg 2004;114:1099–107.
  • 18. Drimouras G, Kostopoulos E, Agiannidis C, Papadodima S, Champ- sas G, Papoutsis I, et al. Redefining vascular anatomy of posterior tibial artery perforators a cadaveric study and review of the literature. Ann Plast Surg 2016;76:705–12.
APA yasar e, DEMİR C, Tekfiliz İ, alagoz m (2022). An idea for bringing the recipient pedicle of cross leg free flap closer: Fasciocutaneous flap above pedicle. , 1701 - 1707. 10.14744/tjtes.2022.97970
Chicago yasar emrah,DEMİR CAN İLKER,Tekfiliz İsmail,alagoz murat sahin An idea for bringing the recipient pedicle of cross leg free flap closer: Fasciocutaneous flap above pedicle. (2022): 1701 - 1707. 10.14744/tjtes.2022.97970
MLA yasar emrah,DEMİR CAN İLKER,Tekfiliz İsmail,alagoz murat sahin An idea for bringing the recipient pedicle of cross leg free flap closer: Fasciocutaneous flap above pedicle. , 2022, ss.1701 - 1707. 10.14744/tjtes.2022.97970
AMA yasar e,DEMİR C,Tekfiliz İ,alagoz m An idea for bringing the recipient pedicle of cross leg free flap closer: Fasciocutaneous flap above pedicle. . 2022; 1701 - 1707. 10.14744/tjtes.2022.97970
Vancouver yasar e,DEMİR C,Tekfiliz İ,alagoz m An idea for bringing the recipient pedicle of cross leg free flap closer: Fasciocutaneous flap above pedicle. . 2022; 1701 - 1707. 10.14744/tjtes.2022.97970
IEEE yasar e,DEMİR C,Tekfiliz İ,alagoz m "An idea for bringing the recipient pedicle of cross leg free flap closer: Fasciocutaneous flap above pedicle." , ss.1701 - 1707, 2022. 10.14744/tjtes.2022.97970
ISNAD yasar, emrah vd. "An idea for bringing the recipient pedicle of cross leg free flap closer: Fasciocutaneous flap above pedicle". (2022), 1701-1707. https://doi.org/10.14744/tjtes.2022.97970
APA yasar e, DEMİR C, Tekfiliz İ, alagoz m (2022). An idea for bringing the recipient pedicle of cross leg free flap closer: Fasciocutaneous flap above pedicle. Ulusal Travma ve Acil Cerrahi Dergisi, 28(12), 1701 - 1707. 10.14744/tjtes.2022.97970
Chicago yasar emrah,DEMİR CAN İLKER,Tekfiliz İsmail,alagoz murat sahin An idea for bringing the recipient pedicle of cross leg free flap closer: Fasciocutaneous flap above pedicle. Ulusal Travma ve Acil Cerrahi Dergisi 28, no.12 (2022): 1701 - 1707. 10.14744/tjtes.2022.97970
MLA yasar emrah,DEMİR CAN İLKER,Tekfiliz İsmail,alagoz murat sahin An idea for bringing the recipient pedicle of cross leg free flap closer: Fasciocutaneous flap above pedicle. Ulusal Travma ve Acil Cerrahi Dergisi, vol.28, no.12, 2022, ss.1701 - 1707. 10.14744/tjtes.2022.97970
AMA yasar e,DEMİR C,Tekfiliz İ,alagoz m An idea for bringing the recipient pedicle of cross leg free flap closer: Fasciocutaneous flap above pedicle. Ulusal Travma ve Acil Cerrahi Dergisi. 2022; 28(12): 1701 - 1707. 10.14744/tjtes.2022.97970
Vancouver yasar e,DEMİR C,Tekfiliz İ,alagoz m An idea for bringing the recipient pedicle of cross leg free flap closer: Fasciocutaneous flap above pedicle. Ulusal Travma ve Acil Cerrahi Dergisi. 2022; 28(12): 1701 - 1707. 10.14744/tjtes.2022.97970
IEEE yasar e,DEMİR C,Tekfiliz İ,alagoz m "An idea for bringing the recipient pedicle of cross leg free flap closer: Fasciocutaneous flap above pedicle." Ulusal Travma ve Acil Cerrahi Dergisi, 28, ss.1701 - 1707, 2022. 10.14744/tjtes.2022.97970
ISNAD yasar, emrah vd. "An idea for bringing the recipient pedicle of cross leg free flap closer: Fasciocutaneous flap above pedicle". Ulusal Travma ve Acil Cerrahi Dergisi 28/12 (2022), 1701-1707. https://doi.org/10.14744/tjtes.2022.97970