CC BY-NC-ND 4.0 · J Reconstr Microsurg Open 2018; 03(02): e70-e73
DOI: 10.1055/s-0038-1675407
Case Report
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Using the Saphenous Artery and Great Saphenous Vein Combined with Anterolateral Thigh Flap to Treat Skin Defects after Amputation

Ling Dong Kong*
1   Department of Orthopedics, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People's Republic of China
,
Han Xiong Cheng*
1   Department of Orthopedics, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People's Republic of China
,
Tao Nie
1   Department of Orthopedics, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People's Republic of China
,
Min Dai
1   Department of Orthopedics, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People's Republic of China
› Author Affiliations
Further Information

Publication History

24 May 2018

30 August 2018

Publication Date:
30 October 2018 (online)

Abstract

Background Aim of this study was to determine the feasibility of using the saphenous artery (SA) and great saphenous vein (GSV) as recipient vessels, combined with anterolateral thigh (ALT) flap, in the treatment of skin defects after lower limb amputation.

Methods From June 2015 to June 2017, 12 patients (average age, 33.5 years; range, 14–56 years; males, 9; female, 3) with large skin defects and symptoms of bone exposure in the proximal lower extremity were included in our study. The patients underwent emergency treatment and multiple debridement combined with vacuum sealing drainage therapy, followed by free flap surgery using the SA and GSV as recipient vessels, and ALT to cover the wound.

Results All 12 patients who underwent free flap surgery survived, but two patients had distal flap necrosis, which, however, was salvaged with conservative measures. All patients were satisfied with the postoperative outcome at the 3 and 6-month follow-up.

Conclusion The SA and GSV can be used as recipient vessels, combined with ALT, to treat skin defects after lower limb amputation.

* Ling Dong Kong and Han Xiong Cheng are co-first authors.


 
  • References

  • 1 MacKenzie EJ, Bosse MJ, Kellam JF. , et al. Characterization of patients with high-energy lower extremity trauma. J Orthop Trauma 2000; 14 (07) 455-466
  • 2 Bibbo C, Nelson J, Fischer JP. , et al. Lower extremity limb salvage after trauma: versatility of the anterolateral thigh free flap. J Orthop Trauma 2015; 29 (12) 563-568
  • 3 Wong CH, Ong YS, Wei FC. The anterolateral thigh-Vastus lateralis conjoint flap for complex defects of the lower limb. J Plast Reconstr Aesthet Surg 2012; 65 (02) 235-239
  • 4 Xu ZF, Sun CF, Duan WY. , et al. Clinical anatomical study and evaluation of the use of the free anteromedial thigh perforator flaps in reconstructions of the head and neck. Br J Oral Maxillofac Surg 2013; 51 (08) 725-730
  • 5 Gong ZJ, Zhang S, Ren ZH, Zhu ZF, Liu JB, Wu HJ. Application of anteromedial thigh flap for the reconstruction of oral and maxillofacial defects. J Oral Maxillofac Surg 2014; 72 (06) 1212-1225
  • 6 Hupkens P, Van Loon B, Lauret GJ. , et al. Anteromedial thigh flaps: an anatomical study to localize and classify anteromedial thigh perforators. Microsurgery 2010; 30 (01) 43-49
  • 7 Cigna E, Chen HC, Ozkan O, Sorvillo V, Maruccia M, Ribuffo D. The anteromedial thigh free flap anatomy: a clinical, anatomical, and cadaveric study. Plast Reconstr Surg 2014; 133 (02) 420-429
  • 8 Meland NB, Fisher J, Irons GB, Wood MB, Cooney WP. Experience with 80 rectus abdominis free-tissue transfers. Plast Reconstr Surg 1989; 83 (03) 481-487
  • 9 Ao M, Nagase Y, Mae O, Namba Y. Reconstruction of posttraumatic defects of the foot by flow-through anterolateral or anteromedial thigh flaps with preservation of posterior tibial vessels. Ann Plast Surg 1997; 38 (06) 598-603
  • 10 Hong JP. The use of supermicrosurgery in lower extremity reconstruction: the next step in evolution. Plast Reconstr Surg 2009; 123 (01) 230-235
  • 11 Choi DH, Goh T, Cho JY, Hong JP. Thin superficial circumflex iliac artery perforator flap and supermicrosurgery technique for face reconstruction. J Craniofac Surg 2014; 25 (06) 2130-2133
  • 12 Zenn MR, Levin LS. Microvascular reconstruction of the lower extremity. Semin Surg Oncol 2000; 19 (03) 272-281
  • 13 Fischer JP, Wink JD, Nelson JA. , et al. A retrospective review of outcomes and flap selection in free tissue transfers for complex lower extremity reconstruction. J Reconstr Microsurg 2013; 29 (06) 407-416
  • 14 Hill JB, Vogel JE, Sexton KW, Guillamondegui OD, Corral GA, Shack RB. Re-evaluating the paradigm of early free flap coverage in lower extremity trauma. Microsurgery 2013; 33 (01) 9-13
  • 15 Kimura N, Saito M, Sumiya Y, Itoh N. Reconstruction of hand skin defects by microdissected mini anterolataral thigh perforator flaps. J Plast Reconstr Aesthet Surg 2008; 61 (09) 1073-1077
  • 16 Bosse MJ, McCarthy ML, Jones AL. , et al; Lower Extremity Assessment Project (LEAP) Study Group. The insensate foot following severe lower extremity trauma: an indication for amputation?. J Bone Joint Surg Am 2005; 87 (12) 2601-2608
  • 17 Yuan F, Chung KC. Impact of safety net hospitals in the care of the hand-injured patient: a national perspective. Plast Reconstr Surg 2016; 138 (02) 429-434
  • 18 Lin YT, Lin CH, Wei FC. More degrees of freedom by using chimeric concept in the applications of anterolateral thigh flap. J Plast Reconstr Aesthet Surg 2006; 59 (06) 622-627
  • 19 Yu P. Inverse relationship of the anterolateral and anteromedial thigh flap perforator anatomy. J Reconstr Microsurg 2014; 30 (07) 463-468
  • 20 Lakhiani C, Lee MR, Saint-Cyr M. Vascular anatomy of the anterolateral thigh flap: a systematic review. Plast Reconstr Surg 2012; 130 (06) 1254-1268
  • 21 Chana JS, Wei FC. A review of the advantages of the anterolateral thigh flap in head and neck reconstruction. Br J Plast Surg 2004; 57 (07) 603-609
  • 22 Tong D, Liu Y, Wu LW, Zhu S, Zhu J, Chen S. Free groin flap for aesthetic and functional donor-site closure of the anterolateral thigh flap. J Plast Reconstr Aesthet Surg 2016; 69 (08) 1116-1120
  • 23 Kang MJ, Chung CH, Chang YJ, Kim KH. Reconstruction of the lower extremity using free flaps. Arch Plast Surg 2013; 40 (05) 575-583