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Free forearm flap for reconstruction of soft tissue defects concurrent with improved peripheral circulation
Journal of Reconstructive Microsurgery
|July 1, 1984
Summary
This study introduces a free forearm flap technique that acts as a bypass, improving lower leg circulation and perfusing flaps. This method enhances blood flow, particularly when lower leg arteries are absent, optimizing reconstructive surgery outcomes.
Area of Science:
- Reconstructive surgery
- Vascular surgery
- Microsurgery
Background:
- Free forearm flaps are standard for lower leg osteitis defects.
- End-to-end arterial anastomoses are preferred when donor and recipient artery sizes match.
- Absence of lower leg arteries contraindicates end-to-end anastomosis due to circulatory risks.
Observation:
- A novel procedure utilizes flap vessels as arterial and venous bypasses.
- This technique improves lower leg circulation while perfusing the flap.
- Cosmetic outcomes at the donor site can be enhanced with split skin grafts and optimal site selection.
Findings:
- The flap can be infolded and connected in various directions, allowing for reverse blood flow.
- Radial artery restoration is possible using a forearm vein graft.
- In 25 cases, arterial bypass was used in 14, venous bypass in 4, with reverse flow in 3.
Implications:
- This bypass technique offers a solution for lower leg reconstructions when recipient arteries are compromised.
- It improves vascularity in the lower leg, aiding flap survival and limb function.
- The method provides a versatile approach to free flap transfer, addressing anatomical challenges.