Abstract
Background Free muscle transfer is the gold standard procedure for functional upper extremity
reconstruction. The gracilis muscle is one of the most commonly used donor muscles
due to the reduced morbidity of its harvest.
Case We performed a free gracilis muscle flap transfer for functional reconstruction of
a forearm after reimplantation in a 62-year-old man with a known deep venous thrombosis
(DVT).
Result Perioperative DVT is a potentially fatal complication due to the risk of pulmonary
embolism. There were many risk factors in this case for venous thromboembolism around
the time of free flap transfer including the length of the operation, intraoperative
position changes, and perioperative suspension of anticoagulants. We divided the operation
into two stages to reduce operative times, chose a donor site that did not require
intraoperative position changes, placed an indwelling temporary filter in the inferior
vena cava preoperatively, and continued administration of anticoagulant intraoperatively.
Conclusion With these measures, we safely and successfully performed free gracilis muscle transfer
in a patient with DVT.
Keywords
forearm amputation - functional free muscle transfer - deep venous thrombosis
