Single-anastomosis femoral arteriovenous shunt as recipient vessels for free-flap reconstruction of a massive lumbosacral wound.

In any reconstructive microsurgical procedure, an adequate recipient circulation is required. None is readily available when reconstructing problem wounds of the lumbosacral spine, leading in some cases to the use of long vein grafts to the axilla to provide vascular access. A case of a massive back wound that was reconstructed microsurgically with a prefabricated preliminary arteriovenous shunt, based on the femoral vessels, is presented. This method takes advantage of the normal anatomic arrangement of the saphenous venous system, requires only one anastomosis, and provides an accessible vascular supply. The technical advantages of the procedure are discussed.