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Case Reports
. 2015 Oct;12(5):598-600.
doi: 10.1111/iwj.12278. Epub 2014 Apr 14.

Emergency arterio-venous loop for free-flap defect reconstruction of the lower thigh with a post-irradiated and heavily infected wound

Christian D Taeger  1 , Andreas Arkudas  1 , Justus P Beier  1 , Raymund E Horch  1
Affiliations
Case Reports

Emergency arterio-venous loop for free-flap defect reconstruction of the lower thigh with a post-irradiated and heavily infected wound

Christian D Taeger et al. Int Wound J. 2015 Oct.

Abstract

Although being a safe and standardised procedure, free-flap reconstruction can be harmful if unpredictable situations occur intraoperatively. The case presented reveals a situation in which an unscheduled interdisciplinary approach allowed to complete our reconstructive aim. An extensive defect at the thigh was planned for reconstruction by means of a free rectus abdominis flap. As the distant part of the flap showed a compromised perfusion during operation and had to be partially discarded, our colleagues from the vascular surgery department created an arterio-venous loop for anastomosis. This allowed a more distant positioning of the flap and ensured a complete defect reconstruction.

Keywords: Arterio-venous loop; Chronic wound; Free-flap; Radiation injury; Thigh.

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Figures

Figure 1
Figure 1
Defect after extensive debridement of all the necrotic tissue.
Figure 2
Figure 2
Reconstruction with a free rectus abdominis muscle in combination with a perforator‐based monitor skin island.
Figure 3
Figure 3
Arterio‐venous (AV)‐loop using the ipsilateral greater saphenous vein, connected with its distal ending to the femoral artery proximal to the defect.
Figure 4
Figure 4
Result 3 months after free‐flap transfer.
See this image and copyright information in PMC

References

    1. Lineaweaver W, Akdemir O, Schleich A. Management strategies following microsurgical flap failure. Microsurgery 2010;30:61–3. - PubMed
    1. Taeger CD, Horch RE, Dragu A, Beier JP, Kneser U. Perforator flaps. A new era in reconstructive surgery. Chirurg 2012;83:163–71. - PubMed
    1. Kneser U, Arkudas A, Beier JP, Dragu A, Stubinger A, Lang W, Horch RE. Extended skin and soft tissue defects after vascular wounds: plastic surgical concepts. Zentralbl Chir 2013;138:536–42. - PubMed
    1. Horch RE, Lang W, Beier JP, Kneser U. Differential indication for autologous bypasses in microsurgical extremity reconstruction. In: Jacobs M, editor. Prevention and management of vascular complications. 2011:175–82.
    1. Beier JP, Horch RE, Dragu A, Arkudas A, Kneser U. Perforator‐based monitoring skin islands in free muscle flaps: teaching old dogs new tricks. Plast Reconstr Surg 2012;129:586e–7. - PubMed

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