Journal of plastic, reconstructive & aesthetic surgery : JPRAS
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J Plast Reconstr Aesthet Surg · Apr 2016
Assessment of sural flap microcirculation: Which position maintains the optimal perfusion?
Limb elevation is a commonly used approach for reducing edema and increasing venous drainage. Considering the anatomy of the sural flap with retrograde perfusion and hence potentially difficult blood outflow, the best angle for positioning the leg following operation is not yet known. ⋯ The results of this study show a more precise pattern of perfusion due to different positioning. The 45° upward position of the leg generally maintains the best blood flow and venous drainage. However, compared to horizontal positioning, these differences were not statistically significant. As an elevation of 45° can be uncomfortable for patients, we recommend an elevation of the leg which approximates the 45° upward position but is still comfortable.
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J Plast Reconstr Aesthet Surg · Apr 2016
Results of combined vascular reconstruction by means of AV loops and free flap transfer in patients with soft tissue defects.
Free flap transplantation to vascular reconstructions as arteriovenous (AV) loops has been established in centers as a feasible therapeutic option for defect reconstruction in the absence of proper recipient vessels, caused by oncologic resections, radiation, or trauma. We report our 10-year experience in free flap transplantation after vascular reconstruction with special emphasis on complication rate and postoperative mobility. ⋯ The 5-year survival rate in long-term follow-up is favorable, despite an initially elevated complication rate. Successful defect coverage can be achieved by this method in a high percentage of patients.