title: Flow-through free latissimus dorsi flap for reconstruction of injured limbs: Evaluation of hemodynamic effects on extremity circulation.
abstract: Management of vascularized injured extremity requires careful reconstruction for continuity of leg circulation. Protection of the remaining intact vessels during free flap transfer provides condition for blood flow maintenance in the distal extremity. Latissimus dorsi muscle has the correct vessel anatomy for applying flow-through flap because it protects recipient vessel integrity during soft tissue reconstruction. Flow-through flap circulation may cause decreasing blood flow in the recipient artery and steal phenomenon in distal circulation although the main vessel remains intact. The purpose of this study was to describe blood flow changes in the recipient artery, flap pedicle, and distal leg circulation at early and long-term follow- up periods. For this purpose, evaluations of blood flows by using Doppler ultrasonography were performed in 2 vascularized injured extremities which were reconstructed with flow-through free latissimus dorsi musculocutaneous flaps. The results demonstrate that flow-through flaps in our vascularized injured extremity did not disturb distal leg circulation in spite of increased blood flow in the recipient and pedicle arteries.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Hacettepe University School of Medicine, Ankara, Turkey. nasirs@ccf.org
authors.forename: Serdar
authors.initials: S
authors.lastname: Nasir
authors.forename: Mustafa Asim
authors.initials: MA
authors.lastname: Aydin
authors.forename: Erhan
authors.initials: E
authors.lastname: Sonmez
authors.forename: Bahattin
authors.initials: B
authors.lastname: Baykal
mesh_terms: D000062:Accidents, Occupational; D000293:Adolescent; D000328:Adult; D006439:Hemodynamics; D006801:Humans; D007866:Leg / Q000098:blood supply*; D007869:Leg Injuries / Q000601:surgery*; D008297:Male; D018482:Muscle, Skeletal / Q000637:transplantation*; D019651:Plastic Surgery Procedures / Q000379:methods*; D013524:Surgical Flaps / Q000098:blood supply*; D016896:Treatment Outcome