Selection of Recipient Vessel in Traumatic Lower Extremity

Abstract

The main focus of this paper is the selection of proper vessels for successful free tissue transfer in lower extremities which have suffered extensive trauma. The selection of proper recipient vessels for traumatized lower extremities still presents difficulties for surgeons. This review will provide a general guideline for the selection of proper recipient vessels in traumatic lower extremity reconstruction and describe the possible reasons why some recipient vessels present more problems than others.

Keywords

recipient vessel - free flap - lower extremity reconstruction

• References

• 1 Byrd HS, Spicer TE, Cierney III G. Management of open tibial fractures. Plast Reconstr Surg 1985; 76 (5) 719-730
• 2 Yaremchuk MJ, Brumback RJ, Manson PN, Burgess AR, Poka A, Weiland AJ. Acute and definitive management of traumatic osteocutaneous defects of the lower extremity. Plast Reconstr Surg 1987; 80 (1) 1-14
• 3 Godina M. Early microsurgical reconstruction of complex trauma of the extremities. Plast Reconstr Surg 1986; 78 (3) 285-292
• 4 Yazar S, Lin CH, Wei FC. One-stage reconstruction of composite bone and soft-tissue defects in traumatic lower extremities. Plast Reconstr Surg 2004; 114 (6) 1457-1466
• 5 Acland RD. Refinements in lower extremity free flap surgery. Clin Plast Surg 1990; 17 (4) 733-744
• 6 Samaha FJ, Oliva A, Buncke GM, Buncke HJ, Siko PP. A clinical study of end-to-end versus end-to-side techniques for microvascular anastomosis. Plast Reconstr Surg 1997; 99 (4) 1109-1111
• 7 Godina M, Arnez ZM, Lister GD. Preferential use of the posterior approach to blood vessels of the lower leg in microvascular surgery. Plast Reconstr Surg 1991; 88 (2) 287-291
• 8 Chen HC, Chuang CC, Chen S, Hsu WM, Wei FC. Selection of recipient vessels for free flaps to the distal leg and foot following trauma. Microsurgery 1994; 15 (5) 358-363
• 9 Park S, Han SH, Lee TJ. Algorithm for recipient vessel selection in free tissue transfer to the lower extremity. Plast Reconstr Surg 1999; 103 (7) 1937-1948
• 10 Heller L, Levin LS. Lower extremity microsurgical reconstruction. Plast Reconstr Surg 2001; 108 (4) 1029-1041 , quiz 1042
• 11 Yazar S, Wei FC, Chen HC , et al. Selection of recipient vessels in double free-flap reconstruction of composite head and neck defects. Plast Reconstr Surg 2005; 115 (6) 1553-1561
• 12 Kolker AR, Kasabian AK, Karp NS, Gottlieb JJ. Fate of free flap microanastomosis distal to the zone of injury in lower extremity trauma. Plast Reconstr Surg 1997; 99 (4) 1068-1073
• 13 Stompro BE, Stevenson TR. Reconstruction of the traumatized leg: use of distally based free flaps. Plast Reconstr Surg 1994; 93 (5) 1021-1025 , discussion 1026–1027
• 14 Hallock GG. Liability of recipient vessels distal to the zone of injury when used for extremity free flaps. J Reconstr Microsurg 1996; 12 (2) 89-92
• 15 Lin CH, Wei FC, Chen CC, Wu WC. Reversed arterial flow in free flap surgery for leg reconstruction. Ann Plast Surg 1997; 39 (6) 590-596
• 16 Chen HC, Mosely LH, Tang YB, Wei FC, Noordhoff MS. Difficult reconstruction of an extensive injury in the lower extremity with a large cross-leg microvascular composite-tissue flap containing fibula. Plast Reconstr Surg 1989; 83 (4) 723-727
• 17 Yamada A, Harii K, Ueda K, Asato H, Tanaka H. Versatility of a cross-leg free rectus abdominis flap for leg reconstruction under difficult and unfavorable conditions. Plast Reconstr Surg 1995; 95 (7) 1253-1257
• 18 Yazar S, Lin CH, Wei FC. Selection of Recipient Vessel in Traumatic Lower Extremity Reconstruction and Evaluation of Complicated Transfers. Presented at: 17th Annual Meeting of European Association of Plastic Surgeons, Program 49–50; Istanbul, 2006
• 19 Walton RL, Rothkopf DM. Judgment and approach for management of severe lower extremity injuries. Clin Plast Surg 1991; 18 (3) 525-543
• 20 Arnez ZM. Immediate reconstruction of the lower extremity—an update. Clin Plast Surg 1991; 18 (3) 449-457
• 21 Schusterman MA, Miller MJ, Reece GP, Kroll SS, Marchi M, Goepfert H. A single center's experience with 308 free flaps for repair of head and neck cancer defects. Plast Reconstr Surg 1994; 93 (3) 472-478 , discussion 479–480
• 22 Taylor GI, Pan WR. Angiosomes of the leg: anatomic study and clinical implications. Plast Reconstr Surg 1998; 102 (3) 599-616 , discussion 617–618
• 23 Cormack GC, Lamberty BGH. The Arterial Anatomy of Skin Flaps. 2nd ed. Edinburgh: Churchill Livingstone; 1994: 244-267
• 24 Urken ML, Vickery C, Weinberg H, Buchbinder D, Biller HF. Geometry of the vascular pedicle in free tissue transfers to the head and neck. Arch Otolaryngol Head Neck Surg 1989; 115 (8) 954-960
• 25 Yaremchuk MJ. Acute management of severe soft-tissue damage accompanying open fractures of the lower extremity. Clin Plast Surg 1986; 13 (4) 621-632
• 26 May Jr JW, Gallico III GG, Jupiter J, Savage RC. Free latissimus dorsi muscle flap with skin graft for treatment of traumatic chronic bony wounds. Plast Reconstr Surg 1984; 73 (4) 641-651
• 27 Wei FC, Chen HC, Chuang CC, Noordhoff MS. Fibular osteoseptocutaneous flap: anatomic study and clinical application. Plast Reconstr Surg 1986; 78 (2) 191-200
• 28 Lin CH, Mardini S, Lin YT, Yeh JT, Wei FC, Chen HC. Sixty-five clinical cases of free tissue transfer using long arteriovenous fistulas or vein grafts. J Trauma 2004; 56 (5) 1107-1117
• 29 Khouri RK, Shaw WW. Reconstruction of the lower extremity with microvascular free flaps: a 10-year experience with 304 consecutive cases. J Trauma 1989; 29 (8) 1086-1094
• 30 Grotting JC. Prevention of complications and correction of postoperative problems in microsurgery of the lower extremity. Clin Plast Surg 1991; 18 (3) 485-489
• 31 Yazar S, Lin CH, Lin YT, Ulusal AE, Wei FC. Outcome comparison between free muscle and free fasciocutaneous flaps for reconstruction of distal third and ankle traumatic open tibial fractures. Plast Reconstr Surg 2006; 117 (7) 2468-2475 , discussion 2476–2477
• 32 Buncke HJ, Alpert B, Shah KG. Microvascular grafting. Clin Plast Surg 1978; 5 (2) 185-194
• 33 Germann G, Steinau HU. The clinical reliability of vein grafts in free-flap transfer. J Reconstr Microsurg 1996; 12 (1) 11-17