Multi-pedicled long fasciocutaneous free flaps in complex lower extremity reconstruction. 2022

Omar Abbassi, and Frances Freer, and Quillan Q Young Sing, and Hidehiko Hoshimatsu, and Ryo Karakawa, and Dajiang Song, and Georgios Pafitanis
Department of Plastic Surgery, Emergency Care and Trauma Division, The Royal London Hospital, Barts Health NHS Trust, London E1 1FR, UK.

Fasciocutaneous free tissue transfer is an established limb salvage modality in lower extremity reconstruction. In severe cases, defect coverage is challenging due to the size and extent of the injury which may surpass the dimensions of most commonly utilized fasciocutaneous donor sites. This is further complicated by the considerable length between the recipient pedicle and most distal segment of the defect requiring coverage. Available donor sites that are able to provide free fasciocutaneous flaps extended length (>40 cm) are combinations between the lateral thoracic, lower abdomen/groin and lateral thigh regions. Advantages of this include a single donor site that can be closed primarily, the ability to utilize healthy vessels outside the zone of trauma/injury for microvascular anastomosis and single stage reconstruction. In addition, from a logistical perspective, single flap harvest would theoretically be more efficient and less resource intensive than harvesting two separate flaps or performing large skin grafts. Herein, we present current available donor sites that allow harvest of long fasciocutaneous free flaps incorporating multiple pedicles with a single skin paddle for lower extremity reconstruction.

UI MeSH Term Description Entries
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D013848 Thigh The superior part of the lower extremity between the HIP and the KNEE. Thighs
D016038 Skin Transplantation The grafting of skin in humans or animals from one site to another to replace a lost portion of the body surface skin. Dermatoplasty,Grafting, Skin,Transplantation, Skin,Dermatoplasties,Graftings, Skin,Skin Grafting,Skin Graftings,Skin Transplantations,Transplantations, Skin
D058752 Free Tissue Flaps A mass of tissue that has been cut away from its surrounding areas to be used in TISSUE TRANSPLANTATION. Free Flaps,Free Tissue Transfer Flaps,Microsurgical Free Flaps,Flap, Free,Flap, Free Tissue,Flap, Microsurgical Free,Flaps, Free,Flaps, Free Tissue,Flaps, Microsurgical Free,Free Flap,Free Flap, Microsurgical,Free Flaps, Microsurgical,Free Tissue Flap,Microsurgical Free Flap,Tissue Flap, Free,Tissue Flaps, Free
D019651 Plastic Surgery Procedures Procedures used to reconstruct, restore, or improve defective, damaged, or missing structures. Cosmetic Reconstructive Surgical Procedures,Cosmetic Surgical Procedures,Esthetic Reconstructive Surgical Procedures,Esthetic Surgical Procedures,Plastic Surgical Procedures,Reconstructive Surgical Procedures,Reconstructive Surgical Procedures, Cosmetic,Cosmetic Reconstructive Surgery,Procedure, Reconstructive Surgical,Procedures, Reconstructive Surgical,Reconstructive Surgical Procedure,Reconstructive Surgical Procedures, Esthetic,Surgical Procedure, Reconstructive,Surgical Procedures, Reconstructive,Cosmetic Reconstructive Surgeries,Cosmetic Surgical Procedure,Esthetic Surgical Procedure,Plastic Surgery Procedure,Plastic Surgical Procedure,Procedure, Cosmetic Surgical,Procedure, Esthetic Surgical,Procedure, Plastic Surgery,Procedure, Plastic Surgical,Procedures, Cosmetic Surgical,Procedures, Esthetic Surgical,Procedures, Plastic Surgery,Procedures, Plastic Surgical,Reconstructive Surgeries, Cosmetic,Reconstructive Surgery, Cosmetic,Surgeries, Cosmetic Reconstructive,Surgery Procedure, Plastic,Surgery Procedures, Plastic,Surgery, Cosmetic Reconstructive,Surgical Procedure, Cosmetic,Surgical Procedure, Esthetic,Surgical Procedure, Plastic,Surgical Procedures, Cosmetic,Surgical Procedures, Esthetic,Surgical Procedures, Plastic
D035002 Lower Extremity The region of the lower limb in animals, extending from the gluteal region to the FOOT, and including the BUTTOCKS; HIP; and LEG. Extremity, Lower,Lower Limb,Membrum inferius,Extremities, Lower,Limb, Lower,Limbs, Lower,Lower Extremities,Lower Limbs

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