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Vascular grafts and flow-through flaps for microsurgical lower extremity reconstruction

(2017) JOURNAL OF RECONSTRUCTIVE MICROSURGERY. 33(suppl. 1). p.S14-S19
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Organization
Abstract
Background: The use of vascular grafts is indicated in case of insufficient pedicle length or for complex defects involving both soft tissues and vessels. Venous grafts (for both venous and arterial reconstructions) and arterial grafts (arterial reconstruction) can be used. This study retrospectively evaluated the needs for vascular reconstruction and its results in a clinical series of lower limb reconstructions with microsurgical free flaps. Materials and Methods: From 2010 to 2015, a total of 16 vascular grafts or flow-through flaps were used in 12 patients out of a total of 150 patients undergoing microsurgical reconstruction (8%). Arterial reconstruction was performed in seven cases (six flow-through flaps, one arterial graft), combined arterial and venous reconstruction in four cases (three vein grafts, one combined venous/arterial graft), and venous reconstruction in one case (one venous graft). The rate of complications and donor-site morbidity related to vascular graft harvest were evaluated. Results: Reconstruction was successful in all cases, despite an overall complication rate of 17 and 8% of surgical revision. Donor-site morbidity, subjectively evaluated, was minimal with respect to functional deficits and aesthetic outcome. Indications for the different types of grafts are discussed. Conclusion: The use of vascular grafts is needed in a relevant percentage of microsurgical reconstruction cases. Venous and arterial vascular grafts, transient arteriovenous fistulas, and flow-through microsurgical flaps showed a safe reconstruction comparable to microsurgical reconstructions without the use of grafts. Donor-site morbidity secondary to vascular graft harvest is minimal, and in almost 70% of cases no additional scars are needed.
Keywords
INTERPOSITION VEIN GRAFTS, RADIAL ARTERY, RANDOMIZED-TRIAL, BYPASS-SURGERY, ARTERIOVENOUS-FISTULAS, ULNAR ARTERY, FOLLOW-UP, PATENCY, CONDUITS, SURVIVAL, vascular grafts, lower limb reconstruction, microsurgery

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MLA
Toia, Francesca, et al. “Vascular Grafts and Flow-through Flaps for Microsurgical Lower Extremity Reconstruction.” JOURNAL OF RECONSTRUCTIVE MICROSURGERY, vol. 33, no. suppl. 1, 2017, pp. S14–19, doi:10.1055/s-0037-1606560.
APA
Toia, F., Zabbia, G., Roggio, T., Pirrello, R., D’Arpa, S., & Cordova, A. (2017). Vascular grafts and flow-through flaps for microsurgical lower extremity reconstruction. JOURNAL OF RECONSTRUCTIVE MICROSURGERY, 33(suppl. 1), S14–S19. https://doi.org/10.1055/s-0037-1606560
Chicago author-date
Toia, Francesca, Giovanni Zabbia, Tiziana Roggio, Roberto Pirrello, Salvatore D’Arpa, and Adriana Cordova. 2017. “Vascular Grafts and Flow-through Flaps for Microsurgical Lower Extremity Reconstruction.” JOURNAL OF RECONSTRUCTIVE MICROSURGERY 33 (suppl. 1): S14–19. https://doi.org/10.1055/s-0037-1606560.
Chicago author-date (all authors)
Toia, Francesca, Giovanni Zabbia, Tiziana Roggio, Roberto Pirrello, Salvatore D’Arpa, and Adriana Cordova. 2017. “Vascular Grafts and Flow-through Flaps for Microsurgical Lower Extremity Reconstruction.” JOURNAL OF RECONSTRUCTIVE MICROSURGERY 33 (suppl. 1): S14–S19. doi:10.1055/s-0037-1606560.
Vancouver
1.
Toia F, Zabbia G, Roggio T, Pirrello R, D’Arpa S, Cordova A. Vascular grafts and flow-through flaps for microsurgical lower extremity reconstruction. JOURNAL OF RECONSTRUCTIVE MICROSURGERY. 2017;33(suppl. 1):S14–9.
IEEE
[1]
F. Toia, G. Zabbia, T. Roggio, R. Pirrello, S. D’Arpa, and A. Cordova, “Vascular grafts and flow-through flaps for microsurgical lower extremity reconstruction,” JOURNAL OF RECONSTRUCTIVE MICROSURGERY, vol. 33, no. suppl. 1, pp. S14–S19, 2017.
@article{8553114,
  abstract     = {{Background: The use of vascular grafts is indicated in case of insufficient pedicle length or for complex defects involving both soft tissues and vessels. Venous grafts (for both venous and arterial reconstructions) and arterial grafts (arterial reconstruction) can be used. This study retrospectively evaluated the needs for vascular reconstruction and its results in a clinical series of lower limb reconstructions with microsurgical free flaps. 
Materials and Methods: From 2010 to 2015, a total of 16 vascular grafts or flow-through flaps were used in 12 patients out of a total of 150 patients undergoing microsurgical reconstruction (8%). Arterial reconstruction was performed in seven cases (six flow-through flaps, one arterial graft), combined arterial and venous reconstruction in four cases (three vein grafts, one combined venous/arterial graft), and venous reconstruction in one case (one venous graft). The rate of complications and donor-site morbidity related to vascular graft harvest were evaluated. 
Results: Reconstruction was successful in all cases, despite an overall complication rate of 17 and 8% of surgical revision. Donor-site morbidity, subjectively evaluated, was minimal with respect to functional deficits and aesthetic outcome. Indications for the different types of grafts are discussed. 
Conclusion: The use of vascular grafts is needed in a relevant percentage of microsurgical reconstruction cases. Venous and arterial vascular grafts, transient arteriovenous fistulas, and flow-through microsurgical flaps showed a safe reconstruction comparable to microsurgical reconstructions without the use of grafts. Donor-site morbidity secondary to vascular graft harvest is minimal, and in almost 70% of cases no additional scars are needed.}},
  author       = {{Toia, Francesca and Zabbia, Giovanni and Roggio, Tiziana and Pirrello, Roberto and D'Arpa, Salvatore and Cordova, Adriana}},
  issn         = {{0743-684X}},
  journal      = {{JOURNAL OF RECONSTRUCTIVE MICROSURGERY}},
  keywords     = {{INTERPOSITION VEIN GRAFTS,RADIAL ARTERY,RANDOMIZED-TRIAL,BYPASS-SURGERY,ARTERIOVENOUS-FISTULAS,ULNAR ARTERY,FOLLOW-UP,PATENCY,CONDUITS,SURVIVAL,vascular grafts,lower limb reconstruction,microsurgery}},
  language     = {{eng}},
  number       = {{suppl. 1}},
  pages        = {{S14--S19}},
  title        = {{Vascular grafts and flow-through flaps for microsurgical lower extremity reconstruction}},
  url          = {{http://doi.org/10.1055/s-0037-1606560}},
  volume       = {{33}},
  year         = {{2017}},
}

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