Journal of reconstructive microsurgery
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J Reconstr Microsurg · May 2008
Anatomic variance in common vascular pedicle of the gracilis and adductor longus muscles: feasibility of double functioning free muscle transplantation with single pedicle anastomosis.
Fifty thighs from fresh human cadavers were studied to evaluate the feasibility of a double functioning free muscle transfer of the gracilis and adductor longus with single common vascular pedicle anastomosis. Methylene blue intra-arterial injection and loupe-magnified dissection were used to demonstrate three groups of vascular patterns in these two muscles. The common vascular pedicles of 88% of our specimen muscles were long enough for possible anastomosis. ⋯ If only one pedicle of this type is harvested during a free gracilis muscle transfer, it may cause inadequate flap perfusion. Four specimens were studied using contrast media angiography to confirm both are Mathes and Nahai type II muscle flaps. In summary, this study typed the common vascular pedicle of our sample of gracilis and adductor longus muscles and confirmed the feasibility of double functioning free muscle transfer of the gracilis and adductor longus with single vascular anastomosis.
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J Reconstr Microsurg · May 2008
Case ReportsEarly free tissue transfer for extremity reconstruction following high-voltage electrical burn injuries.
We compared the effectiveness of free tissue transfer in repairing high-voltage electrical extremity injuries with conventional multistage procedures. Patients were matched for age, sex, level of injury, voltage, and burn surface area; results were compared using the paired Student T test. Free tissue transfer was performed a mean of 19.1 +/- 10.6 days after the injury occurred, and definitive wound closure and limb salvage were achieved in 87.5% of patients after a mean of 23.0 +/- 9.1 days after the injury. ⋯ Both patients required upper and lower proximal ipsilateral limb amputations. One upper-extremity flap failed after pedicle avulsion 4 days after surgery, but a second free tissue transfer was successful in salvaging this limb 4 days later. The number of surgeries, time required to achieve wound closure, and length of hospitalization were all statistically significantly lower in the free flap group compared with those in the conventional treatment group.