J Reconstr Microsurg 1993; 9(1): 5-9
DOI: 10.1055/s-2007-1006632
ORIGINAL ARTICLE

© 1993 by Thieme Medical Publishers, Inc.

Absent Neovascularization in a Lower Extremity Free Flap: A Case Report

Richard C. Sadove, Mark J. Kanter
  • Division of Plastic Surgery, Department of Surgery, University of Kentucky Chandler Medical Center and the Veteran's Affairs Medical Center, Lexington, Kentucky
Further Information

Publication History

Accepted for publication 1992

Publication Date:
08 March 2008 (online)

ABSTRACT

A patient with a free-tissue transfer to the lower leg underwent amputation three months post-operatively. The amputated limb and the free flap were evaluated angiographically immediately following amputation. Vascular injection of the extremity, with clamping of the pedicle, demonstrated that the area of the flap was devoid of radiopaque vessels, and communications from the surrounding tissue were absent. This clinical evidence, added to published clinical reports, suggests that the lower extremity, unlike the head and neck, does not develop collateral circulation to a free-tissue transfer. Late postoperative sacrifice of the vascular pedicle to a lower extremity free-tissue transfer should be approached cautiously, with the realization that collateral circulation is not assured.