Vascularized plantar myocutaneous free flap transfer for amputee stump preparation: a proof of concept cadaver study.

Abstract:

:Lower extremity amputee stump ulceration, irritation, and pain have been a deterrent to consistent long-term or continuous use of lower extremity prosthetics. This study is the first in a series that hypothesizes that these complications can be minimized through the insetting of a vascularized plantar free flap (VPFF) on the amputee stump. Using three hip disarticulated cadaver specimens, a VPFF was designed, dissected, and implanted on one transfemoral and two transtibial stumps. Using accepted vascular anastomosis techniques, the posterior tibial artery was anastomosed to the distal femoral or popliteal artery with corresponding anastomoses for venous drainage. In addition, the possibility of a limited to partial sensate flap may be created with a neurorrhaphy of the associated nerves. This potentially sensate area would provide plantar skin that aids the existing local sensate flap used to close the defect. It is hypothesized that this procedure offers significant rehabilitative and long-term benefits to battlefield or other acute causes for lower extremity amputation. The procedure can be accomplished in battlefield surgical setting as an immediate or delayed inset for some but not all traumatic amputations. Salvaging a partial or complete VPFF from a traumatized foot will obviously be predicated on the degree of trauma to the donor tissue.

journal_name

Mil Med

journal_title

Military medicine

authors

Smith LN,Richards WT,Mozingo DW,Lottenberg L

doi

10.7205/milmed-d-12-00298

subject

Has Abstract

pub_date

2013-02-01 00:00:00

pages

222-7

issue

2

eissn

0026-4075

issn

1930-613X

journal_volume

178

pub_type

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