Using the Descending Branch of the Lateral Circumflex Femoral Artery and Vein as Recipient Vessel for Free Tissue Transfer to the Difficult Areas of the Lower Extremity

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Abstract

Introduction

Free tissue transfer to the areas around the knee or hip can be difficult because there are limited options for reliable recipient vessels, but extended vein grafts may decrease the chance for success. The purpose of this study was to describe our experience with creating a proper recipient vessel for free flap reconstructions in these areas using the descending branch of the lateral circumflex femoral vessels in the thigh.

Methods

Two patients underwent free flap reconstruction of a complex knee wound after orthopedic trauma and a complex hip wound after arthroplasty. A contralateral anterior lateral thigh perforator flap and a latissimus dorsi flap were used to close the wounds, respectively. Dissection was carried between the rectus femoris and vastus lateralis and a recipient vessel was created and placed in more desirable location adjacent to the defect for microvascular anastomoses.

Results

A long 12-cm recipient vessel measuring 1.5 to 2.5 cm in diameter for both artery and vein was dissected and placed in an area adjacent to the defect for a straightforward microvascular microanastomosis. Both patients had successful free tissue reconstructions with uneventful postoperative recoveries. The flaps remained viable and the wounds healed with follow-up, revealing reliable soft tissue and good contour in the reconstructed areas.

Conclusions

The descending branch of the lateral circumflex femoral vessels can be dissected out and serve as a recipient vessel after being placed adjacent to the defect for free tissue transfer to the difficult areas of the lower extremity. Creation of such a recipient vessel would avoid using vein grafts and ease free flap reconstruction to those difficult reconstructive areas.

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