Comparing Outcomes for Fasciocutaneous versus Muscle Flaps in Foot and Ankle Free Flap Reconstruction.

Abstract:

BACKGROUND: The distal lower extremity poses unique reconstructive challenges due to its requirements for durability of the load-bearing plantar surface and for thin, pliable contour in the dorsal foot and ankle region. This study compares outcomes between muscle and fasciocutaneous flaps in patients with foot and ankle defects. METHODS: A retrospective review of soft tissue free flaps used for traumatic foot and ankle defects was performed. Outcomes included takebacks, partial flap failure, total flap failure, and wound complications. RESULTS: A total of 165 cases met inclusion criteria, with muscle flaps (n = 110) comprising the majority. Defects involving the non-weight-bearing surface were more common (n = 86) than those of the weight-bearing surface (n = 79). Complications occurred in 56 flaps (33.9%), including 11 partial losses (6.7%) and 6 complete losses (3.6%). There were no differences in take backs, partial flap failure, or total flap failure between muscle and fasciocutaneous flaps; however, fasciocutaneous flaps had significantly fewer wound complications compared with muscle flaps (7.3% vs. 19.1%, p = 0.046). On multivariable regression analysis, defects of the weight-bearing surface had significantly increased risk of wound breakdown compared with those in the non-weight-bearing surface (odds ratio: 5.05, p = 0.004). CONCLUSION: Compared with fasciocutaneous flaps, muscle flaps demonstrated higher rates of wound complications. While the flap selection in foot and ankle reconstruction depends on the nature of the defect, our findings support the use of fasciocutaneous over muscle flaps in this region.

journal_name

J Reconstr Microsurg

authors

Lee ZH,Abdou SA,Daar DA,Anzai L,Stranix JT,Thanik V,Levine JP,Saadeh PB

doi

10.1055/s-0039-1691785

subject

Has Abstract

pub_date

2019-11-01 00:00:00

pages

646-651

issue

9

eissn

0743-684X

issn

1098-8947

journal_volume

35

pub_type

杂志文章
  • Vascularized nerve tube: an experimental alternative for vascularized nerve grafts over short gaps.

    abstract::Multilayered tubes fabricated from human amnion were placed subcutaneously and/or longitudinally in contact with an axial artery and vein in rats. Histologic evaluation at the third postoperative week showed that the tubes had incorporated with the surrounding fibrovascular tissue. New capillary formation within the t...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章

    doi:10.1055/s-2007-1006749

    authors: Ozcan G,Shenaq S,Spira M

    更新日期:1993-11-01 00:00:00

  • Peripheral nerve regeneration in the apolipoprotein-E-deficient mouse.

    abstract::Apolipoprotein E (apo E) is thought to mediate the reutilization of myelin cholesterol for nerve regeneration. Prior research suggests that apo E is not essential for nerve regeneration following a nerve crush injury. This study was conducted to determine if apo E is essential for nerve regeneration after nerve transe...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章

    doi:10.1055/s-2002-33321

    authors: Genden EM,Watanabe O,Mackinnon SE,Hunter DA,Strasberg SR

    更新日期:2002-08-01 00:00:00

  • Comparative study between acute intraoperative arterial elongation and the use of the interpositional vein graft for arterial reconstruction.

    abstract::This study compares the acute intraoperative arterial elongation technique with the interposition vein-graft method for the closure of small arterial gaps that cannot be repaired by undermining alone. Ten conditioned female mongrel dogs were divided into two groups: a vein graft interposition group and an acute expans...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章

    doi:10.1055/s-2007-1006523

    authors: Ruiz-Razura A,Sozer SO,Layton EG,Hill LH,Cohen BE

    更新日期:1995-03-01 00:00:00

  • Functional limb salvage combining gastrocnemius neurotization and posterior tibial nerve grafting: a case report.

    abstract::Functional limb salvage requires motor and sensory reconstruction of the extremity. An avulsion of the tibial nerve in the popliteal fossa after arthroscopy is presented. Functional limb recovery necessitated intraoperative nerve mapping by awake stimulation, neurotization of the gastrocnemius muscle bellies, and inte...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章

    doi:10.1055/s-2007-1006702

    authors: Francel TJ,Dellon AL

    更新日期:1992-05-01 00:00:00

  • Role of the target in end-to-side neurorrhaphy: reinnervation of a single muscle vs. multiple muscles.

    abstract::The authors examined the effects of end-to-side neurorrhaphy for reinnervation of the musculocutaneous nerve (Group A) which innervates the biceps muscle, compared to reinnervation of the median nerve which innervates multiple muscles in a rat model. Additionally, end-to-end neurorrhaphy to the musculocutaneous nerve ...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章

    doi:10.1055/s-2006-947151

    authors: Lutz BS,Ma SF,Chuang DC,Wei FC

    更新日期:2000-08-01 00:00:00

  • Measuring the pressure in the superficial inferior epigastric vein to monitor for venous congestion in deep inferior epigastric artery perforator breast reconstructions: a pilot study.

    abstract::During deep inferior epigastric artery perforator (DIEP) flap dissection, we noted that in many cases the superficial vein on the ipsilateral side of the flap was engorged and tense, and in others, it was empty. This led us to believe that the pressure is increased as the result of preferential outflow through the sup...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章

    doi:10.1055/s-0029-1243294

    authors: Smit JM,Audolfsson T,Whitaker IS,Werker PM,Acosta R,Liss AG

    更新日期:2010-02-01 00:00:00

  • Effect of time on the viability of ischemic skin flaps treated with vascular endothelial growth factor (VEGF) cDNA.

    abstract::This study examined the efficacy of gene therapy on wound healing. The authors investigated whether delivery of the gene encoding a particular cytokine, known to be important in angiogenesis, could affect ischemic skin flaps. Anterior abdominal skin flaps, based solely on the epigastric artery and vein, were created i...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章

    doi:10.1055/s-2007-1000196

    authors: Taub PJ,Marmur JD,Zhang WX,Senderoff D,Urken ML,Silver L,Weinberg H

    更新日期:1998-08-01 00:00:00

  • Modified chimeric radial collateral artery perforator flap for repairing hand composite defects.

    abstract:BACKGROUND:The authors presented their clinical experience and demonstrated surgical methods for reconstructing complex bone and soft tissue defects of the hand by using modified chimeric radial collateral artery perforator flaps. METHODS:Surgical procedures that employed 16 modified chimeric radial collateral artery ...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章

    doi:10.1055/s-0034-1390324

    authors: Liu J,Song D,Wu S,Li J,Deng X,Li K,Lv H,Xu J

    更新日期:2015-03-01 00:00:00

  • The profunda femoris artery "fourth perforator" island flap: a new perforator flap in lower-limb reconstruction.

    abstract::Although the lateral thigh flap has been well described as a fasciocutaneous flap based on one or more of the four perforators of the profunda femoris artery, the role for these individual perforators as perforator flaps has not been described. These profunda femoris artery perforators offer a particularly useful opti...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章

    doi:10.1055/s-0031-1275494

    authors: Rozen WM,Donahoe S,Wilson JL

    更新日期:2011-05-01 00:00:00

  • A review of therapeutic nerve decompression for neuropathy in Hansen's disease with research suggestions.

    abstract::Nerve decompression surgery for leprosy neuritis has a long history and large literature. New understanding of the high frequency of spontaneous recovery from nerve function impairment requires re-evaluation of the value of decompression in acute nerve dysfunction with strong evidence-based protocols. Several reports ...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章,评审

    doi:10.1055/s-0030-1248237

    authors: Nickerson DS,Nickerson DE

    更新日期:2010-05-01 00:00:00

  • The effect of ammonium sulfate injection on peripheral nerve.

    abstract::Local anesthetic drugs with prolonged nerve-block effect would have clinical application for postoperative or neuromatous pain relief. This study evaluated the possibility of peripheral nerve neurotoxicity by injection of 10 percent ammonium sulfate. Both intrafascicular and extrafascicular injection of 10 percent amm...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章

    doi:10.1055/s-2007-1006418

    authors: Kobayashi J,Mackinnon SE,Langer JC,Hertl MC,Hunter DA,Tarasidis G

    更新日期:1997-08-01 00:00:00

  • The need for preoperative leg angiography in fibula free flaps.

    abstract::Among arterial anatomic conditions which will adversely affect the harvest of the fibula are 1) significant arteriosclerotic disease within the tibial-peroneal vessels; 2) peroneal arteria magna (PAM), a condition in which only the peroneal artery supplies the foot; and 3) absence of the peroneal artery, either congen...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章

    doi:10.1055/s-2007-1006596

    authors: Young DM,Trabulsy PP,Anthony JP

    更新日期:1994-09-01 00:00:00

  • Free vascularized toe-joint transfer in hand reconstruction: a series of 25 patients.

    abstract::Twenty-eight vascularized toe-joint transfers performed on 25 patients were reviewed. A number of different techniques were used: proximal interphalangeal joint or metacarpophalangeal joint reconstruction, one-stage double joint transfer, and interphalangeal thumb or trapezometacarpal joint replacement. Using these ty...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章

    doi:10.1055/s-2007-1006819

    authors: Foucher G,Sammut D,Citron N

    更新日期:1990-07-01 00:00:00

  • Operative Time and Flap Failure in Unilateral and Bilateral Free Flap Breast Reconstruction.

    abstract:BACKGROUND: There is an increasing trend toward bilateral breast reconstruction. Using the National Surgical Quality Improvement Program (NSQIP) database, we sought to understand the association between unilateral and bilateral free flap breast reconstruction and operative time and flap failure. METHODS: We selected a...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章

    doi:10.1055/s-0038-1627445

    authors: Kwok AC,Edwards K,Donato DP,Tatro E,Xu Y,Presson AP,Agarwal JP

    更新日期:2018-07-01 00:00:00

  • Digital neural loops: classification and implications of variation in hand surgery.

    abstract:BACKGROUND:The "neural loop" describes a digital artery passing through a digital nerve, after which both the structures progress distally to supply the digit. While rare, past descriptions refer to neural loops located around the common palmar digital arteries, with no reports of more distal loops. METHODS:We describ...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章

    doi:10.1055/s-0033-1348899

    authors: Niumsawatt V,Rozen WM

    更新日期:2014-01-01 00:00:00

  • Protective effects of monoclonal antibody to intercellular adhesion molecule-1 in venous ischemia-reperfusion injury: experimental study in rats.

    abstract::Flaps with venous occlusion have a decreased survival rate compared with arterial occlusion. It seems that several factors are involved in the etiology of total venous occlusion, including free radicals, edema, thrombosis, and reperfusion injury. In the present study, the authors evaluated the blockage of polymorphonu...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章

    doi:10.1055/s-2006-958701

    authors: Demirseren ME,Sarici M,Gokrem S,Yenidunya S

    更新日期:2007-01-01 00:00:00

  • Epidural anesthesia during lower extremity free tissue transfer.

    abstract::A continuous epidural bupivacaine infusion was used for anesthesia in 20 patients who underwent lower extremity free tissue transfer. In 60 percent of the patients, general anesthesia supplementation with nitrous oxide was used for comfort during prolonged lying on the operating table. In all cases, this technique pro...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章

    doi:10.1055/s-2007-1006939

    authors: Strecker WB,Wood MB,Wedel DJ

    更新日期:1988-07-01 00:00:00

  • Hand Perfusion in Patients with Physiological or Pathological Allen's Tests.

    abstract:BACKGROUND: The Allen test (AT) is a widely used clinical tool for the preoperative assessment of sufficient dual vessel hand perfusion although the impact of a pathological AT on tissue perfusion of the hand is not entirely clear. This study reveals perfusion changes of the hand in patients with pathological and physi...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章

    doi:10.1055/s-0038-1668159

    authors: Bartella AK,Flick N,Kamal M,Steegmann J,Kloss-Brandstätter A,Teichmann J,Hölzle F,Lethaus B

    更新日期:2019-03-01 00:00:00

  • Single-stage maxillary and nasal floor reconstruction with the double-paddle rectus abdominis musculocutaneous free flap.

    abstract::Palatal integrity is essential for useful speech, deglutition, good oral hygiene, and prevention of nasal regurgitation. Maxillary defects after tumor extirpation, therefore, can have serious functional and cosmetic implications. Given the often disappointing results obtained with local and regional pedicled flaps for...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章

    doi:10.1055/s-2007-974647

    authors: Herman CK,Benacquista T,Brindzei N,Berdichevsky M,Baum T,Strauch B

    更新日期:2007-04-01 00:00:00

  • Reconstruction of large traumatic segmental defects of the femur using segmental allograft with vascularized fibula inlay.

    abstract::Segmental defects of the distal femur following trauma pose a reconstructive challenge. A stable reconstruction capable of withstanding high forces while allowing early mobility is paramount. The Capanna technique of reconstruction combining allograft with vascularized bone graft provides such a construct and has been...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章

    doi:10.1055/s-0031-1281520

    authors: Ridha H,Bernard J,Gateley D,Vesely MJ

    更新日期:2011-07-01 00:00:00

  • Rationale for and efficacy of digital arterial reconstruction in scleroderma: report of two cases.

    abstract::Two patients with scleroderma, ischemic pain, non-healing digital ulceration, and digital arterial obstruction were successfully treated with peripheral sympathectomy and digital arterial reconstruction using a reversed small-caliber vein graft. Postoperatively, digital blood flow increased and ulceration healed in bo...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章

    doi:10.1055/s-2002-30181

    authors: Tomaino MM,King J,Medsger T

    更新日期:2002-05-01 00:00:00

  • Mild intraoperative hypothermia reduces free tissue transfer thrombosis.

    abstract::Patients undergoing free tissue transfer are particularly susceptible to hypothermia. The goal was to investigate the impact of intraoperative core body temperature on free flap thrombosis. Two hundred twelve cases of free flap reconstruction at Yale-New Haven Hospital between 1992 and 2008 were reviewed. Free flap th...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章

    doi:10.1055/s-0030-1268211

    authors: Liu YJ,Hirsch BP,Shah AA,Reid MA,Thomson JG

    更新日期:2011-02-01 00:00:00

  • The influence of magnitude and duration of crush load on functional recovery of the peripheral nerve.

    abstract::This study investigated the effect of crush duration at different loads on motor functional recovery. One hundred and thirty-eight rats were divided into five groups: sham operation, resected sciatic nerve, and 100 g, 500 g, and 15,000 g of sciatic crush load (Groups 1 to 5). According to crush duration, Groups 3 and ...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章

    doi:10.1055/s-2007-1006671

    authors: Chen LE,Seaber AV,Urbaniak JR

    更新日期:1993-07-01 00:00:00

  • Targeted Muscle Reinnervation: Outcomes in Treating Chronic Pain Secondary to Extremity Amputation and Phantom Limb Syndrome.

    abstract:BACKGROUND: Secondary to vascular disease, oncological resection, or devastating trauma, lower extremity amputations are performed globally at a yearly rate exceeding 1 million patients. Three-quarters of these patients will develop chronic pain or phantom pain, which presents a functional limitation for prosthetic use...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章

    doi:10.1055/s-0039-1700559

    authors: McNamara CT,Iorio ML

    更新日期:2020-05-01 00:00:00

  • A simplified design of a dual island fasciocutaneous free flap for simultaneous pharyngoesophageal and anterior neck reconstruction.

    abstract::Reconstruction of the pharyngoesophagus and pharynx can be especially challenging in patients with prior irradiation, recurrent disease, and compromised or deficient anterior neck skin. The authors report their experience with seven patients who underwent pharyngoesophageal reconstruction with a new flap design that a...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章

    doi:10.1055/s-2006-932504

    authors: Agarwal JP,Stenson KM,Gottlieb LJ

    更新日期:2006-02-01 00:00:00

  • Morphomic analysis for preoperative donor site risk assessment in patients undergoing abdominal perforator flap breast reconstruction: a proof of concept study.

    abstract:BACKGROUND:Morphomics are three-dimensional measurements of aspects of the human anatomy generated by computed tomographic (CT) imaging. The purpose of this study was to generate preliminary data on the efficacy of morphomics, as a potential risk stratification tool, in predicting abdominal donor site wound-healing com...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章

    doi:10.1055/s-0034-1376400

    authors: Levi B,Rinkinen J,Kidwell KM,Benedict M,Stein IC,Lisiecki J,Enchakalody B,Wang SC,Kozlow JH,Momoh AO

    更新日期:2014-11-01 00:00:00

  • Microsurgical reconstruction during the early puerperium.

    abstract::A transverse rectus abdominis musculocutaneous free flap was electively performed for reconstructing the cutaneous cover in a patient during the early puerperium (12 hr after delivery). This flap was chosen because of the natural expansion achieved by pregnancy, and because it would cover the entire area to be reconst...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章

    doi:10.1055/s-2007-1006478

    authors: Iglesias M,Butrón P,Granados R

    更新日期:1996-05-01 00:00:00

  • Superficial ulnar artery: embryology, case report, and clinical significance in reconstructive microsurgery.

    abstract::In this paper the authors describe and illustrate a rare anatomic variation of the ulnar artery, a superficial ulnar artery. The possible embryologic events responsible for this variation are discussed. In addition, they describe the surgical considerations that should be kept in mind when this abnormality is encounte...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章

    doi:10.1055/s-2007-1000120

    authors: Yuksel M,Yuksel E,Weinfeld AB,Shenaq SM

    更新日期:1999-08-01 00:00:00

  • Diagnostic accuracy of three sensory tests for diagnosis of sensory disturbances.

    abstract:BACKGROUND:Clinical diagnosis of sensory disturbances is extremely challenging, partly because the utility of sensory tests is questionable. Transection of C7 nerve root provides an objective assessment model to determine the diagnostic accuracy of sensory tests. The purpose of this study was to investigate the diagnos...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章

    doi:10.1055/s-0034-1384819

    authors: Li XM,Yang Y,Hou Y,Yang JT,Qin BG,Fu G,Gu LQ

    更新日期:2015-01-01 00:00:00

  • Standardized templates for shaping the fibula free flap in mandible reconstruction.

    abstract::Conversion of the straight fibula bone flap into the parabolic mandible shape can be performed using customized acrylic templates made from a 1:1 mandible computed tomography scan and lateral cephalogram. The premise of the current study is to objectively quantify the variability in a series of acrylic templates used ...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章

    doi:10.1055/s-0033-1356645

    authors: Matros E,Santamaria E,Cordeiro PG

    更新日期:2013-11-01 00:00:00