Early Mobilization after Free-flap Transfer to the Lower Extremities: Preferential Use of Flow-through Anastomosis
Background: Prolonged bed rest and elevation have traditionally been considered necessary after free-flap transfer to the lower extremities. In this retrospective study, we tried to mobilize patients early after free-flap transfer to the lower extremity by means of flow-through anastomosis for both...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer
2014-03-01
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| Series: | Plastic and Reconstructive Surgery, Global Open |
| Online Access: | http://journals.lww.com/prsgo/Fulltext/2014/03000/Article.8.aspx |
| _version_ | 1811269237608546304 |
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| author | Shimpei Miyamoto, MD Shuji Kayano, MD Masahide Fujiki, MD Hirokazu Chuman, MD Akira Kawai, MD Minoru Sakuraba, MD |
| author_facet | Shimpei Miyamoto, MD Shuji Kayano, MD Masahide Fujiki, MD Hirokazu Chuman, MD Akira Kawai, MD Minoru Sakuraba, MD |
| author_sort | Shimpei Miyamoto, MD |
| collection | DOAJ |
| description | Background: Prolonged bed rest and elevation have traditionally been considered necessary after free-flap transfer to the lower extremities. In this retrospective study, we tried to mobilize patients early after free-flap transfer to the lower extremity by means of flow-through anastomosis for both arteries and veins.
Methods: This study included 13 consecutive patients who underwent immediate free-flap transfer after wide resection of soft-tissue tumors of the lower extremity from March 2012 through July 2013. The defects were above the knee in 5 patients and below the knee in 8 patients. In all patients, flow-through anastomosis was used for both arteries and veins. The patients were mobilized starting on the first postoperative day, and their activities of daily life were gradually expanded, depending on the wound conditions. Postoperative complications and the progression of their activities of daily life were investigated retrospectively.
Results: No anastomotic failure or take back occurred. Partial flap necrosis occurred in 1 patient because of a poor perforator but was unrelated to early mobilization. All patients could move to wheelchairs on the first postoperative day. Within 1 week, 12 of 13 patients could start dangling and 10 of 13 patients could start ambulating.
Conclusions: This study demonstrates that early mobilization after free-flap transfer to the lower extremity is made possible by flow-through anastomosis for both arteries and veins. Flow-through flaps have stable circulation from the acute phase and can tolerate early dangling and ambulation. |
| first_indexed | 2024-04-12T21:37:23Z |
| format | Article |
| id | doaj.art-059994d6eec540afbc6ea2ffcc204aa8 |
| institution | Directory Open Access Journal |
| issn | 2169-7574 |
| language | English |
| last_indexed | 2024-04-12T21:37:23Z |
| publishDate | 2014-03-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Plastic and Reconstructive Surgery, Global Open |
| spelling | doaj.art-059994d6eec540afbc6ea2ffcc204aa82022-12-22T03:15:51ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742014-03-0123e12710.1097/GOX.000000000000008001720096-201403000-00008Early Mobilization after Free-flap Transfer to the Lower Extremities: Preferential Use of Flow-through AnastomosisShimpei Miyamoto, MD0Shuji Kayano, MD1Masahide Fujiki, MD2Hirokazu Chuman, MD3Akira Kawai, MD4Minoru Sakuraba, MD5From the Division of Plastic and Reconstructive Surgery, National Cancer Center Hospital, Tokyo, JapanFrom the Division of Plastic and Reconstructive Surgery, National Cancer Center Hospital, Tokyo, JapanDivision of Plastic and Reconstructive Surgery, National Cancer Center Hospital East, Kashiwa, Japan;Division of Orthopedic Surgery, National Cancer Center Hospital, Tokyo, Japan.Division of Orthopedic Surgery, National Cancer Center Hospital, Tokyo, Japan.Division of Plastic and Reconstructive Surgery, National Cancer Center Hospital East, Kashiwa, Japan;Background: Prolonged bed rest and elevation have traditionally been considered necessary after free-flap transfer to the lower extremities. In this retrospective study, we tried to mobilize patients early after free-flap transfer to the lower extremity by means of flow-through anastomosis for both arteries and veins. Methods: This study included 13 consecutive patients who underwent immediate free-flap transfer after wide resection of soft-tissue tumors of the lower extremity from March 2012 through July 2013. The defects were above the knee in 5 patients and below the knee in 8 patients. In all patients, flow-through anastomosis was used for both arteries and veins. The patients were mobilized starting on the first postoperative day, and their activities of daily life were gradually expanded, depending on the wound conditions. Postoperative complications and the progression of their activities of daily life were investigated retrospectively. Results: No anastomotic failure or take back occurred. Partial flap necrosis occurred in 1 patient because of a poor perforator but was unrelated to early mobilization. All patients could move to wheelchairs on the first postoperative day. Within 1 week, 12 of 13 patients could start dangling and 10 of 13 patients could start ambulating. Conclusions: This study demonstrates that early mobilization after free-flap transfer to the lower extremity is made possible by flow-through anastomosis for both arteries and veins. Flow-through flaps have stable circulation from the acute phase and can tolerate early dangling and ambulation.http://journals.lww.com/prsgo/Fulltext/2014/03000/Article.8.aspx |
| spellingShingle | Shimpei Miyamoto, MD Shuji Kayano, MD Masahide Fujiki, MD Hirokazu Chuman, MD Akira Kawai, MD Minoru Sakuraba, MD Early Mobilization after Free-flap Transfer to the Lower Extremities: Preferential Use of Flow-through Anastomosis Plastic and Reconstructive Surgery, Global Open |
| title | Early Mobilization after Free-flap Transfer to the Lower Extremities: Preferential Use of Flow-through Anastomosis |
| title_full | Early Mobilization after Free-flap Transfer to the Lower Extremities: Preferential Use of Flow-through Anastomosis |
| title_fullStr | Early Mobilization after Free-flap Transfer to the Lower Extremities: Preferential Use of Flow-through Anastomosis |
| title_full_unstemmed | Early Mobilization after Free-flap Transfer to the Lower Extremities: Preferential Use of Flow-through Anastomosis |
| title_short | Early Mobilization after Free-flap Transfer to the Lower Extremities: Preferential Use of Flow-through Anastomosis |
| title_sort | early mobilization after free flap transfer to the lower extremities preferential use of flow through anastomosis |
| url | http://journals.lww.com/prsgo/Fulltext/2014/03000/Article.8.aspx |
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