Recipient Vessels for Lower Extremity Free Flap Reconstruction

Abstract

Wounds in the lower extremity may not be amenable to coverage with local tissue. In these instances, free tissue transfer is needed. Finding suitable recipient blood vessels for a microsurgical anastomosis is critical to success. Arterial inflow may be limited because of trauma or atherosclerotic disease. An angiogram can serve as a vascular roadmap for assessing recipient vessels. In general, when large vessels are used as recipient sites, a side branch of the main vessel can be used in an end-to-end fashion. If there are no available side branches, an end-to-side or end-to-end anastomosis to the main vessels may be performed. A thorough vascular exam must be done prior to sacrificing a large artery in the leg. In the lower leg, the tibial vessels are often used in an end-to-end or end-to-side fashion, depending on the overall vascular status.