title: Emergency arterio-venous loop for free-flap defect reconstruction of the lower thigh with a post-irradiated and heavily infected wound.
abstract: Although being a safe and standardised procedure, free-flap reconstruction can be harmful if unpredictable situations occur intraoperatively. The case presented reveals a situation in which an unscheduled interdisciplinary approach allowed to complete our reconstructive aim. An extensive defect at the thigh was planned for reconstruction by means of a free rectus abdominis flap. As the distant part of the flap showed a compromised perfusion during operation and had to be partially discarded, our colleagues from the vascular surgery department created an arterio-venous loop for anastomosis. This allowed a more distant positioning of the flap and ensured a complete defect reconstruction.
authors.affiliation: Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nuernberg, Erlangen, Germany.
authors.forename: Christian D
authors.initials: CD
authors.lastname: Taeger
authors.affiliation: Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nuernberg, Erlangen, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Arkudas
authors.affiliation: Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nuernberg, Erlangen, Germany.
authors.forename: Justus P
authors.initials: JP
authors.lastname: Beier
authors.affiliation: Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nuernberg, Erlangen, Germany.
authors.forename: Raymund E
authors.initials: RE
authors.lastname: Horch
mesh_terms: D000369:Aged, 80 and over; D001166:Arteriovenous Shunt, Surgical; D013293:Enterococcus faecalis; D005263:Femoral Artery / Q000601:surgery*; D058752:Free Tissue Flaps / Q000098:blood supply*; D016908:Gram-Positive Bacterial Infections / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D006801:Humans; D008297:Male; D011552:Pseudomonas Infections / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D011550:Pseudomonas aeruginosa; D019651:Plastic Surgery Procedures / Q000379:methods*; D012501:Saphenous Vein / Q000601:surgery*; D013530:Surgical Wound Infection / Q000382:microbiology / Q000473:pathology / Q000628:therapy*; D013848:Thigh
keywords: Arterio-venous loop; Chronic wound; Free-flap; Radiation injury; Thigh
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