Akyürek Mustafa, Safak Tunç, Ozkan Omer, Keçik Abdullah
Department of Plastic & Reconstructive Surgery, Hacettepe University Medical School, Síhhiye 06100, Ankara, Turkey.
Ann Plast Surg. 2002 Oct;49(4):430-3. doi: 10.1097/01.SAP.0000017989.80979.07.
In this report, a simple technique is described to restore the continuity of the recipient artery in cross-leg free flap procedure after end-to-end anastomoses. In the first stage, the latissimus dorsi flap was revascularized by end-to-end anastomosis between the posterior tibial artery of the noninjured leg and the thoracodorsal artery of the flap. After 4 weeks of neovascularization period, in the second stage when the pedicle was to be divided, the thoracodorsal artery was dissected until its bifurcation in the muscle, transected, and rerouted to the distal ligated end of the posterior tibial artery, accomplishing a simple end-to-end anastomosis between these two vessel ends. Thus, the continuity of the recipient artery was re-accomplished by replacing the normally discarded segment of the flap's arterial pedicle as an arterial graft, the patency of which was demonstrated clinically and by Doppler examination. The authors believe that this technique provides further benefit to the patient by accomplishing vascular flow through a major lower limb artery when the reconstructive pathway involves an end-to-end anastomosis in a cross-leg free flap procedure.
在本报告中，描述了一种简单的技术，用于在交叉腿游离皮瓣手术中进行端端吻合后恢复受区动脉的连续性。在第一阶段，通过将未受伤腿的胫后动脉与皮瓣的胸背动脉进行端端吻合，使背阔肌皮瓣血管化。在4周的新生血管形成期后，在第二阶段，当要切断蒂部时，解剖胸背动脉直至其在肌肉中的分叉处，横断并重新连接至胫后动脉的远端结扎端，在这两个血管端之间完成简单的端端吻合。因此，通过将皮瓣动脉蒂通常被舍弃的部分作为动脉移植物来替代，重新恢复了受区动脉的连续性，其通畅性通过临床和多普勒检查得以证实。作者认为，当重建路径涉及交叉腿游离皮瓣手术中的端端吻合时，该技术通过使血管血流通过一条主要的下肢动脉，为患者带来了进一步的益处。
