Donor Site Morbidity Following Free Tissue Transfer: A Preliminary Survey

1998 ◽  
Vol 6 (2) ◽  
pp. 85-88 ◽  
Author(s):  
James Mahoney ◽  
Eric Kharaillah ◽  
Dimitri Drakos
Keyword(s):  
Wound Healing ◽  
Donor Site ◽  
Free Tissue Transfer ◽  
Free Flaps ◽  
Donor Site Morbidity ◽  
Preliminary Survey ◽  
Retrospective Survey ◽  
Tissue Transfer ◽  
Potential Problems ◽  
Radial Forearm

J Mahoney, E Kharaillah, D Drakos. Donor site morbidity following free tissue transfer: A preliminary survey. Can J Plast Surg 1998;6(2):85-88. Donor site morbidity is becoming an important factor in the measurement of reconstructive success following free tissue transfer. A grading system based on five criteria (cosmesis, functional loss, wound healing, iatrogenic injury and pain) has been devised to evaluate and compare different donor sites in a uniform fashion. Questionnaires were sent to microsurgeons across Canada and to a series of patients asking them to report on their experiences with donor site morbidity. Completed questionnaires from 43 patients and 29 surgeons revealed that overall, donor site morbidity is low. This study represents a retrospective survey of the donor site of various free tissue transfers and highlights potential problems of several frequently used free flaps. The radial forearm flap had the highest morbidity, especially with regard to wound healing and cosmesis. Suggestions to improve studies in this area further are made.

scholarly journals Microsurgical free tissue transfer as avaluable reconstructive procedure in foot reconstruction

2007 ◽  
Vol 40 (02) ◽  
pp. 141-146
Author(s):  
mohamed el-shazly ◽  
mohamed makboul
Keyword(s):  
Free Flap ◽  
Motor Vehicle ◽  
Donor Site ◽  
Free Tissue Transfer ◽  
Free Flaps ◽  
Vehicle Accidents ◽  
Tissue Transfer ◽  
Scapular Flap ◽  
Radial Forearm ◽  
Foot Reconstruction

ABSTRACT Background: owing to the limited soft tissue donor sites in the foot area, the use of microsurgical tissue transfer is frequently becoming mandatory in this area, especially in cases of massive defects due to the common motor vehicle accidents in the territory of upper egypt. free flaps offer a great variety of available tissues to cover larger, multifocal or multistructural defects. they also improve the perfusion of the infected poorly perfused areas.Objectives: in this study, we tried to evaluate foot defects according to their size, shape and site and to determine the general and specific parameters of free tissue transfer to the foot area in concomitance with the patients needs.Materials and methods: eleven patients were included in this study. for each patient, complete history was taken, general and local examination, photographic documentation, laboratory investigations, imaging and other investigations were performed. free flap transfers were applied in all cases as follows: latissimus dorsi flap in five cases, rectus abdominis flap in three cases, scapular flap in one case, gracilis flap in one case and radial forearm flap in one case.Results: nine flaps survived. no infection or donor site complications were recorded. every patient had the optimum free flap as regards the defect size, site, depth, condition, shape, donor site availability and the recipient vessels′ condition.Conclusion: the study of the optimum free flap for foot reconstruction in relation to the defect present and patient conditions is crucial to have significant results.

Microvascular cover in the lower limbIndications and timing, flap types, and technique

2021 ◽  
pp. 601-610
Author(s):  
Zoran M. Arnež
Keyword(s):  
Donor Site ◽  
Free Tissue Transfer ◽  
Free Flaps ◽  
Donor Site Morbidity ◽  
Microvascular Surgery ◽  
The Body ◽  
Potential Donor ◽  
Musculocutaneous Flaps ◽  
Tissue Transfer

Providing adequate and timely soft tissue cover is essential in the treatment of injuries to the lower extremity. Microvascular free tissue transfer is a part of the algorithm of treatment. Free flaps provide the desired quantity and quality of well-vascularized tissue from numerous potential donor sites all over the body, tailored to each specific defect. Microvascular surgery allows single-stage reconstruction of composite defects and is best done early, where possible in the first 24 hours or failing this, during the first week after injury. Free tissue transfer is a complex interdisciplinary procedure and can fail in up to 5% of cases. It is not appropriate for all patients. Free muscle, or musculocutaneous, flaps are ideal for coverage of diaphyseal defects whereas free fasciocutaneous flaps are better for coverage of metaphyseal defects. Perforator free flaps experience little donor site morbidity.

scholarly journals Microsurgery Technique in the Foot Reconstruction of Soft Tissue Defects: A Review of 4 Cases

1970 ◽  
Vol 1 (1) ◽  
Author(s):  
Parintosa Atmodiwirjo ◽  
Afriyanti Sandhi
Keyword(s):  
Soft Tissue ◽  
Donor Site ◽  
Free Tissue Transfer ◽  
Donor Site Morbidity ◽  
Soft Tissue Defects ◽  
Tissue Transfer ◽  
Anterolateral Thigh ◽  
Radial Forearm ◽  
Foot Reconstruction ◽  
Tissue Defects

The restoration of an intact covering is the primary surgical requisite following soft tissue defects in the foot because deep healing can be no better than the surface covering. Soft tissue defects that expose underlying bones, joints, and tendons pose challenging problems and require a free tissue transfer for a successful reconstruction.Total of 4 flaps in the foot was performed between February 2009 to February 2010. We reconstructed soft tissue defects in the foot in 4 patients using 3 free anterolateral thigh (ALT) flaps and 1 free radial forearm (RF) flap. Trauma was the commonest cause in our patients.Free ALT and RF flaps provided stable and durable long-term wound cover in all patients. Complications were few and manageable.Free tissue transfer has become commonplace in many centers around the world. The numerous advantages include stable wound coverage; improve aesthetic and functional outcomes, and minimal donor site morbidity. In our experience, we found that the using of free ALT and RF flaps in foot defects reconstruction, to be technically affordable, reliable and have resulted in excellent outcomes.

scholarly journals Reconstruction of Angle of the Mouth by Microvascular Radial Forearm Free flap- A case report

2014 ◽  
Vol 40 (2) ◽  
pp. 62-64
Author(s):  
MA Litu ◽  
NK Chowdhury ◽  
M Rahman ◽  
S Hassan ◽  
ABM Korshed Alam ◽  
...  
Keyword(s):  
Case Report ◽  
Free Flap ◽  
Donor Site ◽  
Free Tissue Transfer ◽  
The Body ◽  
Radial Forearm Free Flap ◽  
Recipient Site ◽  
Present Case Report ◽  
Tissue Transfer ◽  
Radial Forearm

The terms free flap and free tissue transfer are synonymous used to describe the movement of tissue from one site on the body to another. "Free" implies that the tissue, along with its blood supply, is detached from the original location (donor site) and then transferred to another location (recipient site). However, studies are still going on about the different aspects of its success and failure. The present case report is one such step to share our experience. In this case report successful microvascular free tissue transfer was possible With the increase in experience we can expect increased success rate as well. DOI: http://dx.doi.org/10.3329/bmj.v40i2.18515 Bangladesh Medical Journal 2011 Vol.40(2): 62-64

scholarly journals Double free-flap for a bimalleolar defect of lower leg and ankle

2016 ◽  
Vol 49 (01) ◽  
pp. 95-98
Author(s):  
Naren Shetty ◽  
Narendra S. Mashalkar ◽  
Sunder Raj Ellur ◽  
Karishma Kagodu
Keyword(s):  
Donor Site ◽  
Free Tissue Transfer ◽  
Free Flaps ◽  
Lower Leg ◽  
Donor Site Morbidity ◽  
The Other ◽  
Limb Ischaemia ◽  
Distal Limb ◽  
Limb Defects ◽  
Recipient Vessel

ABSTRACTDouble free-flaps are necessary when tissue cover cannot be sufficed with a single flap. The other factors to be considered when using two free flaps for resurfacing of distal limb defects are the availability of more than one recipient vessel, the risk of distal limb ischaemia and the donor site morbidity of double flap harvest. If these factors are adequately addressed, double free-flaps can be safely executed for resurfacing distal limb defects with minimal morbidity. We report the simultaneous harvest and transfer of the anterolateral and anteromedial thigh flaps inset and vascularised as double free-flaps to resurface a large bimalleolar defect in a 14-year-old boy with no additional morbidity as compared to that of a single free tissue transfer.

Short-term donor site morbidity: A comparison of the anterolateral thigh and radial forearm fasciocutaneous free flaps

Head & Neck ◽  
2015 ◽  
Vol 38 (S1) ◽  
pp. E945-E948 ◽  
Author(s):  
P. Daniel Knott ◽  
Rahul Seth ◽  
Heather H. Waters ◽  
Peter C. Revenaugh ◽  
Daniel Alam ◽  
...  
Keyword(s):  
Donor Site ◽  
Free Flaps ◽  
Donor Site Morbidity ◽  
Short Term ◽  
Anterolateral Thigh ◽  
Radial Forearm

Novel STSG Donor Site for Forearm Flaps: Radial Skin Paddle

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P31-P31
Author(s):  
Tamer Abdel-Halim Ghanem ◽  
Mark K Wax
Keyword(s):  
Free Flap ◽  
Medical Center ◽  
Donor Site ◽  
Free Tissue Transfer ◽  
Free Flaps ◽  
Patch Repair ◽  
Skin Grafts ◽  
Skin Paddle ◽  
Forearm Skin ◽  
Radial Forearm

Objective Split thickness skin grafts (STSG) harvested from the thigh are often utilized to provide coverage for radial forearm donor sites. To eliminate the morbidity of the thigh STSG donor site, we assessed the feasibility of harvesting the STSG from the radial. Methods Prospective data was collected from patients undergoing forearm free flap reconstruction at a tertiary medical center in a 6-month period. The radial forearm free flap (RFFF) harvesting procedure was modified to incorporate STSG harvest from the paddle site as the first step after arm tourniquet activation. Results There were 27 patients in this cohort, with mean age of 68.2. There were 24 fasciocutaneous RFFF, 2 osteocutaneous RFFF, and 1 ulnar flap. The indications for free tissue transfer were as follows: intraoral defects (n=13), pharyngeal patch repair (n=8), total laryngopharyngectomy (n=1), external skin coverage (n=5). The mean forearm defect was 41.2 cm2 (24–77 cm2). 22 out of 27 skin grafts were non-meshed. Harvesting from the forearm skin paddle was successful in 25 patients (93%). Two patients required a thigh STSG; both patients were octagenerians with frail skin. All the forearm donor sites healed well, except one patient required a later revision procedure for exposed tendon. Conclusions Based on this study, the thigh STSG donor site can be eliminated in 9 out of 10 patients undergoing radial forearm free flaps. This translates to decreased risk of pain, infection, and wound oozing. Older patients with frail skin and atrophied forearm muscles were likely to require a thigh donor site.

Outcomes and Utility of Intracranial Free Tissue Transfer

2021 ◽  
pp. 000348942110086
Author(s):  
Heather M. Minchew ◽  
Omar A. Karadaghy ◽  
Paul J. Camarata ◽  
Roukoz B. Chamoun ◽  
Donald David Beahm ◽  
...  
Keyword(s):  
Surgical Repair ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Free Tissue Transfer ◽  
Free Flaps ◽  
Csf Leak ◽  
Serratus Anterior ◽  
Tissue Transfer ◽  
Radial Forearm ◽  
Temporoparietal Fascia Flap

Objective: Complications associated with intracranial vault compromise can be neurologically and systemically devastating. Primary and secondary repair of these deficits require an air and watertight barrier between the intracranial and extracranial environments. This study evaluated the outcomes and utility of using intracranial free tissue transfer as both primary and salvage surgical repair of reconstruction. Methods: A retrospective review was performed of all subjects who underwent intracranial free tissue transfer as primary or salvage repair. Results: A total of 13 intracranial free tissue transfers were performed on 11 subjects: osteocutaneous radial forearm free flaps (n = 6), partial myofascial rectus abdominis flaps (n = 5), temporoparietal fascia flap (n = 1), and serratus anterior myofascial flap (n = 1). Primary reconstruction was performed on 4 subjects with the remaining being salvage repair. Indications for surgery included neoplasm (n = 6 of 11), ballistic trauma (n = 3 of 11), motor vehicle accident (n = 1 of 11), and infection (n = 1 of 11). Three subjects required additional surgical repair for CSF leak and pneumocephalus, with 2 subjects requiring an additional free tissue transfer at a different site. Conclusion: In our experience, free tissue transfer is an effective primary and salvage surgical technique in the reconstruction of complex intracranial problems.

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