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DOI: 10.5999/aps.2012.39.1.55
Scalp Free Flap Reconstruction Using Anterolateral Thigh Flap Pedicle for Interposition Artery and Vein Grafts
Authors
We experienced satisfactory outcomes by synchronously transplanting an artery and vein using an anterolateral thigh flap pedicle between the vascular pedicle and recipient vessel of a flap for scalp reconstruction. A 45-year-old man developed a subdural hemorrhage due to a fall injury. In this patient, the right temporal cranium was missing and the patient had 4×3 cm and 6×5 cm scalp defects. We planned a scalp reconstruction using a latissimus dorsi free flap. Intraoperatively, there was a severe injury to the right superficial temporal vessel because of previous neurosurgical operations. A 15 cm long pedicle defect was needed to reach the recipient facial vessels. For the vascular graft, the descending branch of the lateral circumflex femoral artery and two venae comitantes were harvested.
The flap survived well and the skin graft was successful with no notable complications. When an interposition graft is needed in the reconstruction of the head and neck region for which mobility is mandatory to a greater extent, a sufficient length of graft from an anterolateral flap pedicle could easily be harvested. Thus, this could contribute to not only resolving the disadvantages of a venous graft but also to successfully performing a vascular anastomosis.
This article was presented as a poster at the 68th Congress of the Korean Society of Plastic and Reconstructive Surgeons on November 4-7, 2010 in Seoul, Korea.
Publication History
Received: 13 May 2011
Accepted: 27 June 2011
Article published online:
01 May 2022
© 2012. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)
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References
- 1 Mathes SJ, Hentz VR. Plastic surgery. 2006. 2nd ed. Philadelphia, PA: Saunders Elsevier;
- 2 Urken ML, Cheney ML, Sullivan MJ. et al. Atlas of regional and free flaps for head and neck reconstruction. 1995. New York, NY: Raven Press;
- 3 Baker SR. Microsurgical reconstruction of the head and neck. 1989. New York, NY: Churchill Livingstone;
- 4 Chang KP, Lee HC, Lai CS. et al. Use of single saphenous interposition vein graft for primary arterial circuit and secondary recipient site in head and neck reconstruction: a case report. Head Neck 2007; 29: 412-415
- 5 Friedman JA, Piepgras DG. Current neurosurgical indications for saphenous vein graft bypass. Neurosurg Focus 2003; 14: e1
- 6 Suma H. Arterial grafts in coronary bypass surgery. Ann Thorac Cardiovasc Surg 1999; 5: 141-145
- 7 Fabbrocini M, Fattouch K, Camporini G. et al. The descending branch of lateral femoral circumflex artery in arterial CABG: early and midterm results. Ann Thorac Surg 2003; 75: 1836-1841
- 8 Baskaya MK, Kiehn MW, Ahmed AS. et al. Alternative vascular graft for extracranial-intracranial bypass surgery: descending branch of the lateral circumflex femoral artery. Neurosurg Focus 2008; 24: E8