Use of Muscle Feeding Arteries as Recipient Vessels for Soft Tissue Reconstruction in Lower Extremities
- PDF / 4,269,806 Bytes
- 6 Pages / 595.276 x 841.89 pts (A4) Page_size
- 60 Downloads / 185 Views
40(4):739-744,2020
739
Use of Muscle Feeding Arteries as Recipient Vessels for Soft Tissue Reconstruction in Lower Extremities Jia TIAN, Zhen-bing CHEN, Jin LI# Department of Hand Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China Huazhong University of Science and Technology 2020
Summary: Microsurgical free tissue transfer is still playing an important role in lower extremity reconstruction. Finding a suitable recipient artery for anastomosis is critical in the microsurgical procedure, especially in an extensive wound, or in a complex trauma combined with vascular injury. From April 2014 to March 2018, we retrospectively reviewed patients with traumatic/posttraumatic, oncologic, and electrical wounds in the lower extremity. Those treated with muscle feeding artery as recipient vessels were included. The latissimus dorsi (LD) muscle free flap, anterior lateral thigh (ALT) perforator free flap, and deep inferior epigastric perforator (DIEP) free flap were raised. The muscle feeding arteries to vastus lateral muscle and to medial head of gastrocnemius muscle, concomitant veins, and great saphenous vein were used as recipient vessels. Injuries included in the study were caused by tumour in 2 cases, car accident in 3 cases, crushing in 3 cases, burns in one case, and electrical injury in one case. The wound size varied from 14 cm × 6 cm to 30 cm × 20 cm. LD, ALT, and DIEP free flaps were used in 6, 3, and 4 patients, respectively. The muscle feeding arteries to medial head of gastrocnemius muscle, to sartorius muscle, and to vastus lateral muscle were used as recipient arteries in 4, 5, and one patient, respectively. Concomitant and great saphenous veins were used as recipient veins in 10 and 4 patients, respectively. Using the muscle feeding artery is feasible to avoid injury to the main artery and facilitate dissection and anastomoses, particularly when the wound is located proximal to the mid-third of the lower leg. Key words: muscle feeding artery; recipient vessel; end-to-end anastomosis; end-to-side anastomosis
In lower extremity reconstruction, the main arteries are often injured. Three methods are most commonly used to manage this situation. First, end-to-side (ETS) anastomosis is regularly used, as it is possible to dissect[1]. But it has some disadvantages, such as the impact on the surviving main artery, although this is usually negligible, and does not make use of the injured main artery to reduce the risk of disturbing the normal vessels. Second, the flow-through method is also frequently used to reconstruct the wound and the injured main artery simultaneously[2]. However, it also has some disadvantages, such as a more complicated dissection procedure of raising the flap, more anastomoses between the recipient and donor vessels, and a longer duration for the operation. Third, vessel grafting is very popular in order to reconstruct the wound and the injured main artery in one step[3]. But it also has disadvantages such as additional lesion
Data Loading...
