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Related Experiment Video

Updated: Feb 10, 2026

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Lower-limb reconstruction with chimeric flaps: The quad flap.

Solomon M Azouz1, Nikki A Castel2,3, Aparna Vijayasekaran4

  • 1Division of Plastic and Reconstructive Surgery, Mayo Clinic Hospital, Phoenix, Arizona.

Microsurgery
|May 9, 2018
PubMed
Summary
This summary is machine-generated.

The quad flap, a combination of four free flaps on one pedicle, effectively reconstructs severe lower-extremity injuries. This technique salvages limbs, avoids amputation, and achieves good functional outcomes in complex trauma cases.

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Area of Science:

  • Plastic Surgery
  • Orthopedic Surgery
  • Trauma Surgery

Background:

  • Early soft-tissue coverage is crucial for managing traumatic open lower-extremity wounds.
  • Advancements in free-flap reconstruction enable salvaging previously nonreconstructable injuries.
  • Free-tissue transfer is vital for extensive dead space or exposure of critical structures.

Observation:

  • Two cases of severe lower-extremity crush injuries were treated using the novel quad flap.
  • The quad flap combines parascapular, scapular, serratus, and latissimus dorsi free flaps on a single pedicle.
  • This technique provided substantial soft-tissue coverage for defects including degloving, fractures, and bone exposure.

Findings:

  • Both patients underwent successful reconstruction with contralateral quad free flaps, avoiding amputation.
  • Donor sites were closed primarily with no early flap failures.
  • One patient developed an abscess requiring debridement; no long-term complications were reported in either case.

Implications:

  • The quad flap technique offers a promising solution for complex lower-extremity reconstruction.
  • Successful limb salvage and satisfactory functional and aesthetic outcomes were achieved.
  • Appropriate patient selection and surgical technique are key to the success of the quad flap.