Clinical Research
The application of multiple end-to-side anastomosis in free anterolateral thigh perforator flap transplantation
Zhenjie Ma, Shengjun Yu, Xiao Li, Jingning Li, Yuan Ji, Junjie Jiang, Honglei Dou
Published 2019-02-25
Cite as Chin J Microsurg, 2019, 42(1): 9-12. DOI: 10.3760/cma.j.issn.1001-2036.2019.01.004
Abstract
ObjectiveTo explore the clinical application effect of multiple end-to-side anastomosis in free anterolateral thigh perforator flap transplantation.
MethodsFrom January, 2013 to October, 2017, 29 cases were applied the technology of multiple end-to-side anastomosis to the same recipient vessel in anterolateral thigh perforator flap transplantation for wound repair. Fifteen cases treated with multiple end-to-side anastomosis on flap arteries, and 2-3 arteries were anastomosed, with the average of 2.13. Nine cases were treated with venous multiple end-to-side anastomosis, and 2-4 veins were anastomosed, with the average of 3.11. Five cases treated with arterial and venous multiple end-to-side anastomosis, and 4-6 vessels were anastomosed, with the average of 5.20. Distribution of wounds: 10 cases with hands and wrists wounded, 15 cases with forearms and elbow joints wounded, and 4 cases with lower legs and feet wounded. The soft tissue defect size was 5 cm×13 cm-11 cm×27 cm, and the flap area was 6 cm×15 cm-12 cm×29 cm. Postoperative followed-up was performed every 3-6 months to review flap survival.
ResultsAll flaps of 29 cases survived. Venous congestion occurred in 2 flaps within 48 h after the operation, among which, 1 was overcomed after released the dressing and sutures, and the other underwent surgical exploration. The venous end-to-side anastomotic stomas were unobstructed, and hematoma was formed. After the hematoma compression was removed, circulation was recovered and the flap survived. With followed-up for 6 months to 2.5 years, both donor site and recipient site of the flaps healed well and the injured distal limbs had no hemodynamic disorder.
ConclusionThe application of multiple end-to-side anastomosis to the same recipient vessel for free transplantation of anterolateral thigh perforator flaps is safe and reliable.
Key words:
Anterolateral thigh perforator flaps; Vascular anastomosis; End-to-side anastomosis; Repair; Microsurgical technique
Contributor Information
Zhenjie Ma
Department of Hand Surgery, Yantaishan Hospital, Yantai, Shandong Province 264001, China
Shengjun Yu
Department of Hand Surgery, Yantaishan Hospital, Yantai, Shandong Province 264001, China
Xiao Li
Department of Hand Surgery, Yantaishan Hospital, Yantai, Shandong Province 264001, China
Jingning Li
Department of Hand Surgery, Yantaishan Hospital, Yantai, Shandong Province 264001, China
Yuan Ji
Department of Hand Surgery, Yantaishan Hospital, Yantai, Shandong Province 264001, China
Junjie Jiang
Department of Hand Surgery, Yantaishan Hospital, Yantai, Shandong Province 264001, China
Honglei Dou
Department of Hand and Foot Surgery, Yidu Central Hospital of Weifang, Weifang, Shandong Province 262500, China