title: Dysvascular lower extremity reconstruction using free flaps with a "Y" configuration of the arterial pedicle.
abstract: For patients with a dysvascular lower extremity, free flaps have been transferred by end-to-side anastomosis, in order to maintain peripheral circulation. For such patients, the authors have applied free flap transfers with a "Y" configuration of the arterial pedicle. Eight free flaps with a Y configuration of the arterial pedicle were used in seven patients: latissimus dorsi musculocutaneous flaps in six, and scapular flaps in two. For the former, flaps were harvested with the subscapular and circumflex scapular arteries forming a Y pedicle in three cases, and with the thoracodorsal artery and the branch of the serratus anterior muscle in three. For the scapular flap transfers, the flap was harvested with the subscapular and thoracodorsal arteries forming a Y pedicle in one case, and with the circumflex scapular artery and the descending branch in the other. This procedure was performed for single-artery extremities in two cases. One developed arterial thrombosis of the branch to the foot, but removal of the thrombus and reanastomosis resulted in peripheral blood circulation being maintained. Eventually, all flaps survived. This procedure is indicated in patients with lower-leg reconstruction, especially with vascular disease.
authors.affiliation: Department of Orthopaedic Surgery, Nara Medical University, 840 Shijyo-cho, Kashihara, Nara 634-8522, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yajima
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Kobata
authors.forename: Koji
authors.initials: K
authors.lastname: Shigematsu
authors.forename: Kenji
authors.initials: K
authors.lastname: Kawamura
authors.forename: Shohei
authors.initials: S
authors.lastname: Omokawa
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Takakura
mesh_terms: D000328:Adult; D000368:Aged; D062109:Dermatologic Surgical Procedures; D005260:Female; D005597:Fractures, Open / Q000601:surgery*; D006801:Humans; D007871:Leg Ulcer / Q000601:surgery*; D035002:Lower Extremity / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D012867:Skin / Q000473:pathology; D013524:Surgical Flaps / Q000098:blood supply*; D016896:Treatment Outcome; D014652:Vascular Diseases / Q000473:pathology / Q000601:surgery*