title: Combined vascular reconstruction and microvascular muscle flap transfer for salvage of ischaemic legs with major tissue loss and wound complications.
abstract: OBJECTIVE
  To assess the safety and short-term efficacy of combined vascular revascularisation and free microvascular muscle flap transfer in patients with advanced lower limb ischaemia caused by occlusive arterial disease.
  
  
  METHODS
  A prospective follow-up study of 2-72 months.
  
  
  METHODS
  Academic referral centre.
  
  
  METHODS
  Consecutive first 15 patients with extensive tissue loss due to advanced leg ischaemia or wound complications after bypass surgery.
  
  
  METHODS
  Graft patency, free tissue transfer viability, amputation rate.
  
  
  RESULTS
  There was no perioperative mortality. The cumulative rates for secondary vascular patency, microvascular graft viability and limb salvage were 80%, 87% and 76% at one year provided that vessels and grafts that were functioning at the time of amputation were considered lost to follow-up rather than failed at that point. If, however, amputation was also regarded as vessel and graft failure the corresponding rates were 68%, 62% and 76%, respectively.
  
  
  CONCLUSIONS
  Combining microvascular muscle flap transfer with vascular reconstruction for salvage of legs with extended ischaemic tissue loss or wound complications after bypass surgery gave acceptable preliminary results and deserves an attempt in selected patients.
authors.affiliation: Department of Surgery, Helsinki University, Central Hospital, Finland.
authors.forename: M
authors.initials: M
authors.lastname: Lepäntalo
authors.forename: E
authors.initials: E
authors.lastname: Tukiainen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical; D001157:Arterial Occlusive Diseases / Q000601:surgery*; D001158:Arteries / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000209:etiology; D006085:Graft Survival; D006801:Humans; D007511:Ischemia / Q000601:surgery*; D007866:Leg / Q000098:blood supply* / Q000601:surgery; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000000981:diagnostic imaging / Q000637:transplantation*; D011183:Postoperative Complications; D011446:Prospective Studies; D012449:Safety; D013524:Surgical Flaps / Q000379:methods*; D018616:Ultrasonography, Doppler, Duplex; D014654:Vascular Patency