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Anterolateral thigh free flap using modified turbocharging method: a case report.

Yooseok Ha¹, Donghyun Kim¹, Hyeokjae Kwon¹

¹Department of Plastic and Reconstructive Surgery, Chungnam National University Hospital, Daejeon, Republic of Korea.

Frontiers in Surgery

|October 16, 2024

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Free flap surgery can face arterial insufficiency complications in patients with poor circulation. A modified turbocharging technique, involving anastomosing an additional perforator, successfully improved blood flow in the flap.

Area of Science:

Plastic Surgery
Vascular Surgery
Microsurgery

Background:

Free flaps are crucial for reconstructing soft tissue defects, particularly around the ankle.
Arterial insufficiency is a significant post-operative complication in free flap surgery, especially in patients with compromised lower leg circulation.
Vessel anastomosis during surgery is a critical step where this complication can arise.

Observation:

The study observed a complication of arterial insufficiency immediately after vessel anastomosis in free flap surgery.
This complication was noted in patients presenting with pre-existing poor lower leg circulation.
The primary pedicle's distal end was identified as a site for potential intervention.

Findings:

A modified turbocharging technique was employed to address the observed arterial insufficiency.

Keywords:

anterolateral thigh perforator flap salvage technique soft tissue defect reconstruction turbocharging

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This technique involved anastomosing an additional perforator to the distal end of the main pedicle.

The modified turbocharging method demonstrated success in improving blood circulation within the free flap.

Implications:

This technique offers a potential solution to improve free flap viability in patients with compromised circulation.
Enhanced blood flow can reduce the risk of flap failure and improve reconstructive outcomes.
The modified turbocharging method represents a valuable advancement in microsurgical reconstruction techniques.