Short interposed pedicle of flow-through anterolateral thigh flap for reliable reconstruction of damaged upper extremity.
In microvascular reconstructive surgery, the recipient vessel in free flap transfer is often sacrificed to provide the vascular pedicle anastomosis. As the recipient vessel is likely to be necessary for distal circulation in the damaged upper extremity, preserving its patency is critical. Flow-through anastomosis is one method that preserves the recipient vessel's patency. We present here eight patients who underwent upper-extremity reconstructions with a free flow-through anterolateral thigh flap. The flap's short vascular pedicle was interposed into a division of the radial artery and anastomosed on both sides of the pedicle's T-shaped arterial segment. The flow-through flap has various advantages, not only making it possible to reconstruct both vessels and soft tissues but also preserving recipient vessels and balancing the blood supply or pressure in the flap. In clinical situations that do not require reconstruction of the artery, the short interposed pedicle of the free anterolateral thigh flow-through flap offers a versatile and reliable option for microsurgical reconstruction of defects in the upper extremities.
Division of Plastic Surgery, Graduate School of Biochemical Science, Hiroshima, Japan. kyokota@hiroshima-u.ac.jp
Kazunori
K
Yokota
Toru
T
Sunagawa
Osami
O
Suzuki
Misa
M
Nakanishi
Mitsuo
M
Ochi
D000293:Adolescent; D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical; D001134:Arm Injuries / Q000175:diagnosis / Q000601:surgery*; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection; D006085:Graft Survival; D006230:Hand Injuries / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008833:Microcirculation / Q000502:physiology; D008866:Microsurgery / Q000379:methods; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods*; D012039:Regional Blood Flow / Q000502:physiology; D018570:Risk Assessment; D012494:Sampling Studies; D017695:Soft Tissue Injuries / Q000175:diagnosis / Q000601:surgery; D013524:Surgical Flaps / Q000098:blood supply*; D013848:Thigh / Q000601:surgery; D013997:Time Factors; D014945:Wound Healing / Q000502:physiology; D055815:Young Adult