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Updated: Jan 10, 2026

Orthotopic Hind-Limb Transplantation in Rats

Orthotopic Hind-Limb Transplantation in Rats

Published on: July 12, 2010

Algorithmic recipient vessel selection for vessel-depleted lower limbs.

Alex Sorkin¹, Chad Chang², Marco Marcasciano³

¹Division of Plastic and Reconstructive Surgery, Department of Surgery, China Medical University Hospital, Taichung, Taiwan; Department of Plastic and Reconstructive Surgery, Shamir Medical Center (Assaf Harofeh), Zerifin, Israel.

Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS

|November 26, 2025

Summary

This summary is machine-generated.

This study developed an algorithm for selecting recipient vessels in lower limb free flap reconstruction, improving outcomes by matching vessel availability to reconstructive techniques.

Keywords:

Algorithm Free flap Lower limb reconstruction Recipient vessel Vascular bridge

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Area of Science:

Microsurgery
Vascular Surgery
Reconstructive Surgery

Background:

Lower limb reconstruction presents challenges in recipient vessel selection.
Optimal outcomes depend on precise vessel choice based on defect characteristics and local vasculature.

Purpose of the Study:

To develop and validate an algorithm for selecting recipient vessels in lower limb free flap reconstruction.
The algorithm considers defect location, size, composition, and lower limb vasculature.

Main Methods:

Retrospective review of 518 lower limb free flap reconstructions (1983-2022).
Development of a classification algorithm based on vascular availability.
Matching patients to appropriate reconstructive techniques.

Main Results:

Algorithm created four patient groups based on vascular availability.
Group I (419 patients): Direct anastomosis to suitable flaps.
Group II (25 patients): Free flap with long pedicle to medial sural artery.
Group III (21 patients): Vein loop or two free flaps using thigh vessels.
Group IV (53 patients): Two-stage procedure with a bridge flap for limb defects with no available vessels.

Conclusions:

The developed algorithm provides a systematic and reproducible method.
It aids in selecting recipient vessels for microsurgical lower limb reconstruction.