Clinical advances in free tissue flaps for the treatment of wounds without anastomotic vessels or requiring difficult anastomotic vessels

doi:10.3877/cma.j.issn.1673-9450.2023.05.014

Abstract

Abstract:

The wound without or with difficulties in vascular anastomosis is a kind of complex wounds caused by trauma, tumor, operation, radiation therapy, and other causes. The lack of blood vessels in the recipient area makes it challenging to repair wound using conventional methods. Therefore, establishing new blood vessels that can support free tissue flap transfer is crucial. Surgeons employ various solutions to construct anastomotic vessels in the recipient area, including vascular bundle transplantation, which may involve autogenous vein or artificial blood vessels, cross-crossing leg-free skin flaps, flow-through flaps, and end-to-patch anastomosis. Once established, these anastomotic vessels serve as a foundation for therapeutic approaches such as free skin flap, muscle flap, fascia flap, greater omentum flap, and other methods used to repair wounds and cure diseases. This article reviews the characteristics and existing solutions of vascular anastomosis without or with difficulties, aiming to provide with such challenges. It clinical decision-making and treatment strategies for surgeons faced underscores the importance of establishing new blood vessels in the recipient area to support free tissue flap transfer and highlights the clinical techniques utilized to achieve successful outcomes.

Key words: Transplantation, Microsurgery, Surgical flaps, Vessel defect, Flow-through

Hao Zhang, Wanfu Zhang, Fei Han, Lin Tong, Yunwei Wang, Shaohui Li, Yang Chen, Peng Cao, Hao Guan. Clinical advances in free tissue flaps for the treatment of wounds without anastomotic vessels or requiring difficult anastomotic vessels[J]. Chinese Journal of Injury Repair and Wound Healing(Electronic Edition), 2023, 18(05): 442-446.

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