Free Flap Salvage in the Ischemic Foot: A Case Report

We performed distal bypass and free flap transfer in a single-stage operation to repair an extensive soft tissue defect in an ischemic foot of an 84-year-old woman. The nutrient artery of the free flap was anastomosed to the bypass graft in an end-to-side manner. Subsequently, the bypass graft becam...

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Bibliographic Details
Main Authors: Dongkyung Seo, Yutaka Dannnoura, Riku Ishii, Keisuke Tada, Kunihiro Kawashima, Tetsunori Yoshida, Katsumi Horiuchi
Format: Article
Language:English
Published: Thieme Medical Publishers, Inc. 2022-09-01
Series:Archives of Plastic Surgery
Subjects:
Online Access:http://www.thieme-connect.de/DOI/DOI?10.1055/s-0042-1756341
Description
Summary:We performed distal bypass and free flap transfer in a single-stage operation to repair an extensive soft tissue defect in an ischemic foot of an 84-year-old woman. The nutrient artery of the free flap was anastomosed to the bypass graft in an end-to-side manner. Subsequently, the bypass graft became occluded on several occasions. Although intravascular and surgical interventions were performed each time, the bypass graft eventually became completely occluded. However, despite late occlusion of the nutrient artery, the free flap has remained viable and the patient is ambulatory. The time required for a transplanted free flap to become completely viable without a nutrient artery is likely longer for an ischemic foot compared with a healthy foot. However, the exact period of time required is not known. A period of month was required in our patient. We report this case to help clarify the process by which a free flap becomes viable when applied to an ischemic foot.
ISSN:2234-6163
2234-6171