Analysis of Recipient Vessel in Free Tissue Transfer to Lower Extremity.

Park, Sang Hoon; Han, Sang Hoon; Lee, Taik Jong

Original Article

Journal of the Korean Society of Plastic and Reconstructive Surgeons 1999;26(1):35-42.
Published online January 1, 1999.

Analysis of Recipient Vessel in Free Tissue Transfer to Lower Extremity.

Sang Hoon Park, Sang Hoon Han, Taik Jong Lee

Department of Plastic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Abstract

The proper selection of recipient vessel for free tissue transfer to the lower extremity cannot be overemphasized. However, there has been no systematic analysis or general guideline that every surgeon can depend upon. A retrospective review of 50 consecutive microvascular free flaps to the lower extremity was carried out to identify the patterns, results and problems in recipient vessel selection. From September 1990 to December 1997, 50 cases of microvascular free tissue transfer were performed to the lower extremity. The causes requiring soft tissue coverage were trauma(25), unstable scar(11), tumor(7), and chronic osteomyelits(7). The follow-up period ranged from 2 to 41 months. The posterior tibial vessel was used as a recipient in 25 cases while anterior tibial vessel was used in 21 cases. The microvascular anastomosis was done proximal to the injury in 45 cases. The arterial anastomosis was done in end-to-side fashion in 6 cases while all the venous anastomoses were done in end-to-end fashion. There were 3 failed flaps and the overall success rate was 94%. The site and extent of injury, the vascular status of lower extremity, the kind of flap to be used and the method of microvascular anastomosis are factors to be considered in free tissue transfer to lower extremity.