Archives of Plastic Surgery

Korean Society of Plastic and Reconstructive Surgeons (대한성형외과학회)
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Scalp Free Flap Reconstruction Using Anterolateral Thigh Flap Pedicle for Interposition Artery and Vein Grafts

  • Park, Jun-Hyung (Department of Plastic and Reconstructive Surgery, Eulji General Hospital, Eulji University School of Medicine) ;
  • Min, Kyung-Hee (Department of Plastic and Reconstructive Surgery, Eulji General Hospital, Eulji University School of Medicine) ;
  • Eun, Suk-Chan (Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine) ;
  • Lee, Jong-Hoon (Department of Plastic and Reconstructive Surgery, Eulji General Hospital, Eulji University School of Medicine) ;
  • Hong, Sung-Hee (Department of Plastic and Reconstructive Surgery, Eulji General Hospital, Eulji University School of Medicine) ;
  • Kim, Chin-Whan (Department of Plastic and Reconstructive Surgery, Eulji General Hospital, Eulji University School of Medicine)
  • Received : 2011.05.13
  • Accepted : 2011.06.27
  • Published : 2012.01.15
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Abstract

We experienced satisfactory outcomes by synchronously transplanting an artery and vein using an anterolateral thigh flap pedicle between the vascular pedicle and recipient vessel of a flap for scalp reconstruction. A 45-year-old man developed a subdural hemorrhage due to a fall injury. In this patient, the right temporal cranium was missing and the patient had $4{\times}3cm$ and $6{\times}5cm$ scalp defects. We planned a scalp reconstruction using a latissimus dorsi free flap. Intraoperatively, there was a severe injury to the right superficial temporal vessel because of previous neurosurgical operations. A 15 cm long pedicle defect was needed to reach the recipient facial vessels. For the vascular graft, the descending branch of the lateral circumflex femoral artery and two venae comitantes were harvested. The flap survived well and the skin graft was successful with no notable complications. When an interposition graft is needed in the reconstruction of the head and neck region for which mobility is mandatory to a greater extent, a sufficient length of graft from an anterolateral flap pedicle could easily be harvested. Thus, this could contribute to not only resolving the disadvantages of a venous graft but also to successfully performing a vascular anastomosis.

Keywords

References

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  3. Reconstruction with fibular osteocutaneous free flap in patients with mandibular osteoradionecrosis vol.37, pp.None, 2015, https://doi.org/10.1186/s40902-015-0007-3
  4. Modification of pedicle lengthening through perforator transposition in free anterolateral thigh flaps with pedicle size discrepancy: A case report vol.38, pp.1, 2012, https://doi.org/10.1002/micr.30207
  5. Facial Artery as a Recipient Vessel for Extensive Scalp Reconstruction With Free Omental Flap Without Vein Graft vol.29, pp.3, 2012, https://doi.org/10.1097/scs.0000000000004309
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  7. Immediate Lower Extremity Reconstruction Using an Anterolateral Thigh Free Flap With Simultaneous Interposition Graft of Descending Branches of Lateral Circumflex Femoral Vessels vol.18, pp.1, 2012, https://doi.org/10.1177/1534734618819932
  8. Chimeric Anterolateral Thigh Flap in Skull Base Reconstruction: A Case-Based Update and Literature Review vol.11, pp.8, 2012, https://doi.org/10.3390/brainsci11081076