ABSTRACT
Partial free flap failure can sometimes be more exasperating than total failure as
the reason may be unknown, the best potential recipient site has already been violated,
and the risk of undertaking a mandatory second free flap perhaps too extenuating.
Muscle perforator flaps, often for inexplicable reasons, are also susceptible to partial
flap necrosis. However, the large source vessel to their requisite perforator(s) can
serve as a convenient second recipient site for attachment as a “flow-through” to
another perforator free flap to salvage the overall reconstruction. In a metachronous
fashion, this would represent a sequential chimeric perforator-based free flap and
proves to be yet another inherent advantage of muscle perforator flaps.
KEYWORDS
Muscle perforator flap - chimeric free flap - sequential microsurgical tissue transfer
REFERENCES
- 1
Hallock G G.
Partial failure of a free flap salvaged by using the surviving portion as a “bridge”
flap for revascularizing a second free flap.
Plast Reconstr Surg.
1997;
100
981-985
- 2
Weinzweig N, Gonzalez M.
Free tissue failure is not an all-or-none phenomenon.
Plast Reconstr Surg.
1995;
96
648-660
- 3
Vasconez L.
2005 Jurkiewicz Lecture.
Ann Plast Surg.
2006;
56
1-8
- 4
Hallock G G.
The fate of the failed second-attempt free flap.
Ann Plast Surg.
2001;
47
41-46
- 5
Fearon J A, Cuadros C L, May Jr J W.
Flap failure after microvascular free-tissue transfer: the fate of a second attempt.
Plast Reconstr Surg.
1990;
86
746-751
- 6
Oliva A, Lineaweaver W C, Buncke H J et al..
Salvage of wounds following failed tissue transplantation.
J Reconstr Microsurg.
1993;
9
257-263
- 7
Hallock G G.
Liability of recipient vessels distal to the zone of injury when used for extremity
free flaps.
J Reconstr Microsurg.
1996;
12
89-92
- 8
Nakatsuka T, Harii K, Ebihara S.
An inferior rectus abdominis bridge flap for revascularization of an ischemic tongue.
Ann Plast Surg.
1994;
32
97-100
- 9
Chen H C, Tang Y B, Noordhoff M S.
Reconstruction of the entire esophagus with “chain flaps” in a patient with severe
corrosive injury.
Plast Reconstr Surg.
1989;
84
980-984
- 10
Brandt K, Khouri R K, Upton J.
Free flaps as flow-through vascular conduits for simultaneous coverage and revascularization
of the hand or digit.
Plast Reconstr Surg.
1996;
98
321-327
- 11
Koshima I, Kawada S, Etoh H, Kawamura S, Moriguchi T, Sonoh H.
Flow-through anterior thigh flaps for one-stage reconstruction of soft-tissue defects
and revascularization of ischemic extremities.
Plast Reconstr Surg.
1995;
95
252-260
- 12
Koshima I, Yamamoto H, Hosoda M, Moriguchi T, Orita Y, Nagayama H.
Free combined composite flaps using the lateral circumflex femoral system for repair
of massive defects of the head and neck regions: an introduction to the chimeric flap
principle.
Plast Reconstr Surg.
1993;
92
411-420
- 13
Hallock G G.
Further clarification of the nomenclature for compound flaps.
Plast Reconstr Surg.
2006;
117
151e-160e
- 14
Saint-Cyr M, Wong C, Schaverien M, Mojallal A, Rohrich R J.
The perforasome theory: vascular anatomy and clinical implications.
Plast Reconstr Surg.
2009;
124
1529-1544
- 15
Schaverien M, Saint-Cyr M, Arbique G, Hatef D, Brown S A, Rohrich R J.
Three- and four-dimensional computed tomographic angiography and venography of the
anterolateral thigh perforator flap.
Plast Reconstr Surg.
2008;
121
1685-1696
- 16
Acland R D, Anderson G, Siemionow M, McCabe S.
Direct in vivo observations of embolic events in the microcirculation distal to a
small-vessel anastomosis.
Plast Reconstr Surg.
1989;
84
280-288
discussion 289
- 17 Hallock G G.
Complications of fasciocutaneous flaps including donor site treatment. In: Hallock GG Fasciocutaneous Flap. Boston; Blackwell Scientific 1992: 157-170
Geoffrey G HallockM.D.
1230 S. Cedar Crest Blvd., Suite 306, Allentown
PA 18103
Email: pbhallock@cs.com
