Transposition flap and skin graft techniques for optimizing anastomosis coverage.

Area of Science:

• Microsurgery
• Reconstructive Surgery
• Plastic Surgery

Background:

• Free tissue transfer surgeries, especially for lower limb reconstruction using Thoracodorsal Artery Perforator (TDAP) flaps, often face challenges with anastomosis site tension.
• This tension can compromise surgical success and lead to complications.

Purpose of the Study:

• To evaluate a novel technique combining transposition flaps with Split-Thickness Skin Grafts (STSG) for managing anastomosis site tension.
• To assess the efficacy and safety of this combined approach in TDAP free flap procedures.

Main Methods:

• A retrospective analysis of 20 patients undergoing TDAP free flap procedures with anticipated anastomosis site tension was performed.
• The study involved meticulous surgical documentation and postoperative monitoring of outcomes, focusing on complications and overall success.

Main Results:

• No complete flap failures were observed, indicating the viability of the combined technique.
• Minor complications included partial tip necrosis of transposition flaps (2 cases) and partial graft loss of STSGs (2 cases), both managed successfully via secondary intention healing.

Conclusions:

• The integration of transposition flaps with STSG effectively alleviates tension at anastomosis sites in TDAP free flap reconstructions.
• This approach shows promise in reducing postoperative complications and enhancing the long-term success of reconstructive microsurgery.
• Further research is recommended to validate this technique in broader microsurgical applications.