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Vein/Arterial Grafts Harvested within the Incision for a Free Groin Flap.

Matsuda K, Tomita K, Fukai M, Kubo T, Hayashi A, Shibata M, Hosokawa K - Plast Reconstr Surg Glob Open (2015)

Bottom Line: The free groin flap results in less donor-site morbidity than other skin flaps and is suitable for use in children and adolescents.To overcome this limitation, we harvested vein and arterial grafts from the flap elevation area without placing additional skin incisions.This procedure may expand the indications for free groin flap transfer.

View Article: PubMed Central - PubMed

Affiliation: Department of Plastic and Reconstructive Surgery, Niigata University Graduate School of Medicine, Niigata, Japan; Department of Plastic and Reconstructive Surgery, Osaka University Graduate School of Medicine, Osaka, Japan; and Department of Plastic and Reconstructive Surgery, Toho University Sakura Medical Center, Chiba, Japan.

ABSTRACT
The free groin flap results in less donor-site morbidity than other skin flaps and is suitable for use in children and adolescents. However, the vascular pedicle is relatively short and vessel diameter is small, which makes vascular anastomosis technically difficult. To overcome this limitation, we harvested vein and arterial grafts from the flap elevation area without placing additional skin incisions. Use of short (2-3 cm) vein/arterial grafts greatly simplified flap insetting and vascular anastomosis. This procedure may expand the indications for free groin flap transfer.

No MeSH data available.


Related in: MedlinePlus

A photograph of case 1 at 3 months postoperatively shows complete wound healing.
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Figure 3: A photograph of case 1 at 3 months postoperatively shows complete wound healing.

Mentions: An 8-year-old boy with open metatarsal fractures and degloving injury to the dorsum of the left foot was primarily treated by placement of artificial dermis. Ten days after artificial dermis application, open reduction and artificial bone grafting were performed, followed by free groin flap coverage. First, the dorsalis pedis artery was dissected as a recipient artery; however, blood flow was not sufficient to perfuse the free flap. The recipient artery was then switched to the posterior tibial artery, which required extension of the flap vascular pedicle. To avoid placing an extra skin incision for vein graft harvest, branches of the GSV were harvested as a 2-cm-long graft and anastomosed to the flap, to elongate the vascular pedicle. However, the length of the vascular pedicle was not sufficient to reach the posterior tibial artery. Therefore, a 2-cm-long SIEA was harvested from the flap dissection area, and these two grafts were chained, which allowed the vascular pedicle to be extended by 4 cm. This was followed by end-to-side anastomosis to the posterior tibial artery. The vein of the flap was anastomosed to the cutaneous vein in the dorsum of the foot in end-to-end fashion (Fig. 2). The flap survived completely and the donor-site wound healed well (Fig. 3).


Vein/Arterial Grafts Harvested within the Incision for a Free Groin Flap.

Matsuda K, Tomita K, Fukai M, Kubo T, Hayashi A, Shibata M, Hosokawa K - Plast Reconstr Surg Glob Open (2015)

A photograph of case 1 at 3 months postoperatively shows complete wound healing.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4494477&req=5

Figure 3: A photograph of case 1 at 3 months postoperatively shows complete wound healing.
Mentions: An 8-year-old boy with open metatarsal fractures and degloving injury to the dorsum of the left foot was primarily treated by placement of artificial dermis. Ten days after artificial dermis application, open reduction and artificial bone grafting were performed, followed by free groin flap coverage. First, the dorsalis pedis artery was dissected as a recipient artery; however, blood flow was not sufficient to perfuse the free flap. The recipient artery was then switched to the posterior tibial artery, which required extension of the flap vascular pedicle. To avoid placing an extra skin incision for vein graft harvest, branches of the GSV were harvested as a 2-cm-long graft and anastomosed to the flap, to elongate the vascular pedicle. However, the length of the vascular pedicle was not sufficient to reach the posterior tibial artery. Therefore, a 2-cm-long SIEA was harvested from the flap dissection area, and these two grafts were chained, which allowed the vascular pedicle to be extended by 4 cm. This was followed by end-to-side anastomosis to the posterior tibial artery. The vein of the flap was anastomosed to the cutaneous vein in the dorsum of the foot in end-to-end fashion (Fig. 2). The flap survived completely and the donor-site wound healed well (Fig. 3).

Bottom Line: The free groin flap results in less donor-site morbidity than other skin flaps and is suitable for use in children and adolescents.To overcome this limitation, we harvested vein and arterial grafts from the flap elevation area without placing additional skin incisions.This procedure may expand the indications for free groin flap transfer.

View Article: PubMed Central - PubMed

Affiliation: Department of Plastic and Reconstructive Surgery, Niigata University Graduate School of Medicine, Niigata, Japan; Department of Plastic and Reconstructive Surgery, Osaka University Graduate School of Medicine, Osaka, Japan; and Department of Plastic and Reconstructive Surgery, Toho University Sakura Medical Center, Chiba, Japan.

ABSTRACT
The free groin flap results in less donor-site morbidity than other skin flaps and is suitable for use in children and adolescents. However, the vascular pedicle is relatively short and vessel diameter is small, which makes vascular anastomosis technically difficult. To overcome this limitation, we harvested vein and arterial grafts from the flap elevation area without placing additional skin incisions. Use of short (2-3 cm) vein/arterial grafts greatly simplified flap insetting and vascular anastomosis. This procedure may expand the indications for free groin flap transfer.

No MeSH data available.


Related in: MedlinePlus