Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Experiment Video

Updated: Aug 3, 2025

A Model of Free Tissue Transfer: The Rat Epigastric Free Flap
10:10

A Model of Free Tissue Transfer: The Rat Epigastric Free Flap

Published on: January 15, 2017

16.8K

Technical Variables in Lower Extremity Free Flap Reconstruction.

Joani M Christensen1, Leah Ahn2, Mara Z Meulendijks2

  • 1Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, Saint Louis, Missouri.

Journal of Reconstructive Microsurgery
|April 11, 2023
PubMed
Summary

Related Concept Videos

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

Emergency Free Flap Reconstruction in Traumatic Extremity Injuries: Clinical Indications and Framework.

Microsurgery·2026
Same author

Targeted Muscle Reinnervation for Management and Prevention of Symptomatic Neuroma.

Muscle & nerve·2026
Same author

Porcine xenotransplantation in the clinical era: converging advances and unresolved barriers on the path to clinical translation - a narrative review.

Frontiers in immunology·2026
Same author

Hydrogel-Encapsulated Primed MSCs Enhance Regeneration in Full-Thickness Porcine Burn Wounds.

Tissue engineering. Part A·2026
Same author

Algorithm for Surgical Management of Symptomatic Hand and Digital Neuromas.

Plastic and reconstructive surgery. Global open·2026
Same author

Pilot Study: DermiSphere: A Novel Hydrogel with Collagen Microspheres Dermal Regeneration Template.

Plastic and reconstructive surgery. Global open·2026
Same journal

Interest in Robotics Outpaces Access: Results from A Survey of Practicing Plastic Surgeons.

Journal of reconstructive microsurgery·2026
Same journal

Enhancing Microvascular Anastomosis Using an Axial-View Microscope.

Journal of reconstructive microsurgery·2026
Same journal

Beyond BMI: Using Abdominal Wall Thickness to Guide Patient Selection for DIEP Flap Breast Reconstruction.

Journal of reconstructive microsurgery·2026
Same journal

Influence of Body Mass Index on Perioperative Outcomes of Oncologic Head and Neck Free Flaps: Comprehensive Analysis Using a Prospective Institutional Database.

Journal of reconstructive microsurgery·2026
Same journal

Homocysteine Levels as a Potential Contributor to Impaired Wound Healing in Plastic and Reconstructive Surgery.

Journal of reconstructive microsurgery·2026
Same journal

Infrared Temperature Monitoring in Vascularized Flaps with Simulated Arterial and Venous Thrombosis: An Animal Study.

Journal of reconstructive microsurgery·2026
See all related articles
This summary is machine-generated.

Lower extremity free flap reconstruction success rates are high, but using arteries other than the posterior tibial or anterior tibial can increase complications. Arterial anastomosis revisions negatively impact flap survival.

Area of Science:

  • Microsurgery
  • Plastic Surgery
  • Vascular Surgery

Background:

  • Lower extremity free flaps have higher failure rates compared to other body regions.
  • Previous research often examined individual technical variables in free tissue reconstruction, not their interrelationships.
  • This study investigates how variations in intraoperative microsurgical techniques affect free flap outcomes in lower extremity reconstruction.

Approach:

  • A retrospective review of 410 patients undergoing 420 free flap lower extremity reconstructions at two Level 1 trauma centers (2002-2020).
  • Data collected included demographics, comorbidities, indications, intraoperative details, and complications.
  • Bivariate analysis was used to assess outcomes such as flap failure and thrombosis.

Key Points:

More Related Videos

Engineered Vascularized Muscle Flap
08:18

Engineered Vascularized Muscle Flap

Published on: January 11, 2016

8.3K
A Pre-clinical Rat Model for the Study of Ischemia-reperfusion Injury in Reconstructive Microsurgery
08:05

A Pre-clinical Rat Model for the Study of Ischemia-reperfusion Injury in Reconstructive Microsurgery

Published on: November 8, 2019

7.4K

Related Experiment Videos

Last Updated: Aug 3, 2025

A Model of Free Tissue Transfer: The Rat Epigastric Free Flap
10:10

A Model of Free Tissue Transfer: The Rat Epigastric Free Flap

Published on: January 15, 2017

16.8K
Engineered Vascularized Muscle Flap
08:18

Engineered Vascularized Muscle Flap

Published on: January 11, 2016

8.3K
A Pre-clinical Rat Model for the Study of Ischemia-reperfusion Injury in Reconstructive Microsurgery
08:05

A Pre-clinical Rat Model for the Study of Ischemia-reperfusion Injury in Reconstructive Microsurgery

Published on: November 8, 2019

7.4K
  • Total flap failure occurred in 4.9%, partial flap failure in 5.9%, and unplanned reoperation in 9.0%.
  • Complications were linked to recipient artery choice (non-PT/AT/DP arteries) and arterial revisions.
  • Arterial anastomosis revisions were associated with total flap failure, while recipient artery choice correlated with partial flap failure.

    • Conclusions:

    • While numerous techniques exist for lower extremity free flap reconstruction, achieving high success rates is possible.
    • Utilizing arterial inflow sources beyond the posterior tibial (PT) and anterior tibial (AT)/dorsalis pedis (DP) arteries increases overall complication and partial flap failure rates.
    • Intraoperative revision of arterial anastomosis is a predictor of poorer flap survival.