Using the descending branch of the lateral circumflex femoral artery and vein as recipient vessel for free tissue transfer to the difficult areas of the lower extremity

David Wade Dorfman, Lee Li-Qun Pu

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

INTRODUCTION: Free tissue transfer to the areas around the knee or hip can be difficult because there are limited options for reliable recipient vessels, but extended vein grafts may decrease the chance for success. The purpose of this study was to describe our experience with creating a proper recipient vessel for free flap reconstructions in these areas using the descending branch of the lateral circumflex femoral vessels in the thigh. METHODS: Two patients underwent free flap reconstruction of a complex knee wound after orthopedic trauma and a complex hip wound after arthroplasty. A contralateral anterior lateral thigh perforator flap and a latissimus dorsi flap were used to close the wounds, respectively. Dissection was carried between the rectus femoris and vastus lateralis and a recipient vessel was created and placed in more desirable location adjacent to the defect for microvascular anastomoses. RESULTS: A long 12-cm recipient vessel measuring 1.5 to 2.5 cm in diameter for both artery and vein was dissected and placed in an area adjacent to the defect for a straightforward microvascular microanastomosis. Both patients had successful free tissue reconstructions with uneventful postoperative recoveries. The flaps remained viable and the wounds healed with follow-up, revealing reliable soft tissue and good contour in the reconstructed areas. CONCLUSIONS: The descending branch of the lateral circumflex femoral vessels can be dissected out and serve as a recipient vessel after being placed adjacent to the defect for free tissue transfer to the difficult areas of the lower extremity. Creation of such a recipient vessel would avoid using vein grafts and ease free flap reconstruction to those difficult reconstructive areas.

Original languageEnglish (US)
Pages (from-to)397-400
Number of pages4
JournalAnnals of Plastic Surgery
Volume70
Issue number4
DOIs
StatePublished - Apr 2013

Fingerprint

Femoral Vein
Femoral Artery
Lower Extremity
Thigh
Free Tissue Flaps
Wounds and Injuries
Veins
Quadriceps Muscle
Hip
Knee
Perforator Flap
Transplants
Superficial Back Muscles
Arthroplasty
Orthopedics
Dissection
Arteries

Keywords

  • Free tissue transfer
  • Hip
  • Knee
  • Lateral circumflex femoral vessel
  • Recipient vessel

ASJC Scopus subject areas

  • Surgery

Cite this

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title = "Using the descending branch of the lateral circumflex femoral artery and vein as recipient vessel for free tissue transfer to the difficult areas of the lower extremity",
abstract = "INTRODUCTION: Free tissue transfer to the areas around the knee or hip can be difficult because there are limited options for reliable recipient vessels, but extended vein grafts may decrease the chance for success. The purpose of this study was to describe our experience with creating a proper recipient vessel for free flap reconstructions in these areas using the descending branch of the lateral circumflex femoral vessels in the thigh. METHODS: Two patients underwent free flap reconstruction of a complex knee wound after orthopedic trauma and a complex hip wound after arthroplasty. A contralateral anterior lateral thigh perforator flap and a latissimus dorsi flap were used to close the wounds, respectively. Dissection was carried between the rectus femoris and vastus lateralis and a recipient vessel was created and placed in more desirable location adjacent to the defect for microvascular anastomoses. RESULTS: A long 12-cm recipient vessel measuring 1.5 to 2.5 cm in diameter for both artery and vein was dissected and placed in an area adjacent to the defect for a straightforward microvascular microanastomosis. Both patients had successful free tissue reconstructions with uneventful postoperative recoveries. The flaps remained viable and the wounds healed with follow-up, revealing reliable soft tissue and good contour in the reconstructed areas. CONCLUSIONS: The descending branch of the lateral circumflex femoral vessels can be dissected out and serve as a recipient vessel after being placed adjacent to the defect for free tissue transfer to the difficult areas of the lower extremity. Creation of such a recipient vessel would avoid using vein grafts and ease free flap reconstruction to those difficult reconstructive areas.",
keywords = "Free tissue transfer, Hip, Knee, Lateral circumflex femoral vessel, Recipient vessel",
author = "Dorfman, {David Wade} and Pu, {Lee Li-Qun}",
year = "2013",
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doi = "10.1097/SAP.0b013e3182853d49",
language = "English (US)",
volume = "70",
pages = "397--400",
journal = "Annals of Plastic Surgery",
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publisher = "Lippincott Williams and Wilkins",
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TY - JOUR

T1 - Using the descending branch of the lateral circumflex femoral artery and vein as recipient vessel for free tissue transfer to the difficult areas of the lower extremity

AU - Dorfman, David Wade

AU - Pu, Lee Li-Qun

PY - 2013/4

Y1 - 2013/4

N2 - INTRODUCTION: Free tissue transfer to the areas around the knee or hip can be difficult because there are limited options for reliable recipient vessels, but extended vein grafts may decrease the chance for success. The purpose of this study was to describe our experience with creating a proper recipient vessel for free flap reconstructions in these areas using the descending branch of the lateral circumflex femoral vessels in the thigh. METHODS: Two patients underwent free flap reconstruction of a complex knee wound after orthopedic trauma and a complex hip wound after arthroplasty. A contralateral anterior lateral thigh perforator flap and a latissimus dorsi flap were used to close the wounds, respectively. Dissection was carried between the rectus femoris and vastus lateralis and a recipient vessel was created and placed in more desirable location adjacent to the defect for microvascular anastomoses. RESULTS: A long 12-cm recipient vessel measuring 1.5 to 2.5 cm in diameter for both artery and vein was dissected and placed in an area adjacent to the defect for a straightforward microvascular microanastomosis. Both patients had successful free tissue reconstructions with uneventful postoperative recoveries. The flaps remained viable and the wounds healed with follow-up, revealing reliable soft tissue and good contour in the reconstructed areas. CONCLUSIONS: The descending branch of the lateral circumflex femoral vessels can be dissected out and serve as a recipient vessel after being placed adjacent to the defect for free tissue transfer to the difficult areas of the lower extremity. Creation of such a recipient vessel would avoid using vein grafts and ease free flap reconstruction to those difficult reconstructive areas.

AB - INTRODUCTION: Free tissue transfer to the areas around the knee or hip can be difficult because there are limited options for reliable recipient vessels, but extended vein grafts may decrease the chance for success. The purpose of this study was to describe our experience with creating a proper recipient vessel for free flap reconstructions in these areas using the descending branch of the lateral circumflex femoral vessels in the thigh. METHODS: Two patients underwent free flap reconstruction of a complex knee wound after orthopedic trauma and a complex hip wound after arthroplasty. A contralateral anterior lateral thigh perforator flap and a latissimus dorsi flap were used to close the wounds, respectively. Dissection was carried between the rectus femoris and vastus lateralis and a recipient vessel was created and placed in more desirable location adjacent to the defect for microvascular anastomoses. RESULTS: A long 12-cm recipient vessel measuring 1.5 to 2.5 cm in diameter for both artery and vein was dissected and placed in an area adjacent to the defect for a straightforward microvascular microanastomosis. Both patients had successful free tissue reconstructions with uneventful postoperative recoveries. The flaps remained viable and the wounds healed with follow-up, revealing reliable soft tissue and good contour in the reconstructed areas. CONCLUSIONS: The descending branch of the lateral circumflex femoral vessels can be dissected out and serve as a recipient vessel after being placed adjacent to the defect for free tissue transfer to the difficult areas of the lower extremity. Creation of such a recipient vessel would avoid using vein grafts and ease free flap reconstruction to those difficult reconstructive areas.

KW - Free tissue transfer

KW - Hip

KW - Knee

KW - Lateral circumflex femoral vessel

KW - Recipient vessel

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