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Case Reports
. 2023 Dec 28;2023(12):rjad683.
doi: 10.1093/jscr/rjad683. eCollection 2023 Dec.

Usefulness of perforating branches of the deep femoral artery and vein as recipient vessels during free-flap reconstruction for extensive defects of the thigh

Makoto Miyamae  1 , Ryotaro Urabe  1 , Kunihiro Nakai  1
Affiliations
Case Reports

Usefulness of perforating branches of the deep femoral artery and vein as recipient vessels during free-flap reconstruction for extensive defects of the thigh

Makoto Miyamae et al. J Surg Case Rep. .

Abstract

The perforating branches of the deep femoral artery and vein are considered useful recipient vessels during free-flap reconstruction for extensive defects extending from the knee to the mid-thigh or from the lateral to the posterior region of the thigh. Despite being located deep between the adductor longus and magnus muscles, they can be easily identified, allowing for a sufficient surgical field for the vascular anastomosis. Approximately four perforators from the deep femoral artery can be found on the posterior aspect of the thigh, easily identified by dissecting the semitendinosus and biceps femoris muscles. The calibre and length of the perforators were suitable for vascular anastomosis. In this study, we present three cases of free-flap reconstruction for extensive thigh defects using perforating branches of the deep femoral artery and vein as recipient vessels.

Keywords: deep femoral artery; deep femoral vein; perforator; recipient vessel; reconstruction; thigh.

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Conflict of interest statement

None declared.

Figures

Figure 1
Figure 1
Intraoperative photographs of Case 1. A 59-year-old man underwent extensive tumour resection of the front of the thigh and reconstruction by free latissimus dorsi myocutaneous flap. (a) The skin defect on the front of the thigh after the extensive tumour resection. (b) Skin coverage after the reconstruction by free latissimus dorsi myocutaneous flap. (c) The thoracodorsal artery and vein, which feed the latissimus dorsi myocutaneous flap, were anastomosed to the second perforating branches of the deep femoral artery and vein, respectively.
Figure 2
Figure 2
Intraoperative photographs of Case 2. A 53-year-old man underwent extensive tumour resection of the medial distal thigh and reconstruction by free latissimus dorsi myocutaneous flap. (a) The skin defect from the medial thigh to the medial knee joint after the extensive tumour resection. (b) Skin coverage after the reconstruction by free latissimus dorsi myocutaneous flap. (c) The thoracodorsal artery and vein, which feed the latissimus dorsi myocutaneous flap, were anastomosed to the terminal branches of the deep femoral artery and vein.
Figure 3
Figure 3
Intraoperative photographs of Case 3. A 73-year-old man underwent debridement for a left greater trochanteric ulcer and reconstruction by free latissimus dorsi myocutaneous flap. (a) The skin defect on the lateral thigh after the debridement of the ulcer. (b) Skin coverage after the reconstruction by free latissimus dorsi myocutaneous flap. (c) The thoracodorsal artery and vein, which feed the latissimus dorsi myocutaneous flap, were anastomosed to the third perforating branches of the deep femoral artery and vein.
See this image and copyright information in PMC

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