Double arterialized free jejunal flap.
In a standard free jejunal transfer, one artery and one vein are anastomosed. However, when raising the jejunal flap, a one-segment jejunum sometimes has two arteries and one accompanying vein as a vascular pedicle. Free jejunal transfer in which two arteries and one vein are anastomosed was designed. We report on the safety and advantages of using this artery-dominant transfer when performing microvascular anastomosis. This technique was used when a one-segment jejunum had two arteries and an accompanying vein. Eight patients underwent this arterial-supercharged free jejunal transfer. All flaps survived, and no complications developed except for two cases of intraoperative thrombosis before the procedure. It is important to transfer the artery-rich graft into the same physiological environment by reconstructing the similar hemodynamics. The grafts can be transferred without harm. This artery-dominant method can be an option when conditions are unfavorable for safer jejunal transfer.
Numajiri
Toshiaki
T
Department of Plastic and Reconstructive Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan. prs-bin@koto.kpu-m.ac.jp
Sowa
Yoshihiro
Y
Nishino
Kenichi
K
Fujiwara
Hitoshi
H
Nakano
Hiroshi
H
Shimada
Taketoshi
T
Nakai
Shigeru
S
Hisa
Yasuo
Y
D000368:Aged; D000714:Anastomosis, Surgical; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D007583:Jejunum / Q000637:transplantation*; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D010610:Pharyngeal Neoplasms / Q000601:surgery*; D011183:Postoperative Complications; D019651:Plastic Surgery Procedures / Q000379:methods*; D013524:Surgical Flaps / Q000098:blood supply*