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Single stage arteriovenous short saphenous loops in microsurgical reconstruction of the lower extremity

  • Trauma Surgery
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Abstract

The short saphenous vein can be used “in situ” to create a temporary arteriovenous shunt for lengthening the recipient vessels of the injured limb in microsurgical reconstructions of the lower extremity. We report our results using this single-anastomosis turnover technique in three high-energy trauma patients who presented open tibial fractures associated with vascular injuries. The construction of the arteriovenous fistula provided arterial access and venous drainage to a free latissimus dorsi flap that was transferred to cover the soft tissue defect. In all three cases, this single stage procedure was successful; the flap survived and provided good long term results. The use of the ipsilateral small saphenous vein “in situ” for immediate arteriovenous loop formation may be of great value in complex lower leg reconstructions. It is a reliable adjunctive technique that provides healthy vessels to supply the free flap, permitting stable wound coverage and high rate of limb salvage.

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References

  1. Vlastou C, Earle AS, Jordan R (1992) Vein grafts in reconstructive microsurgery of the lower extremity. Microsurgery 13:234–235

    Article  PubMed  CAS  Google Scholar 

  2. Vlastou C, Earle AS (1988) Short saphenous vein grafts as an aid to microsurgical reconstruction of the lower extremity. J Reconstr Microsurg 4(2):145–154

    Article  PubMed  CAS  Google Scholar 

  3. Silveira LF, Patricio JA (1933) Arteriovenous fistula with a saphenous long loop. Microsurgery 14(7):444–445

    Article  Google Scholar 

  4. Atiyeh BS, Khalil IM, Hussein MK, Al Amm CA, Musharafieh RS (2001) Temporary arteriovenous fistula and microsurgical free tissue transfer for reconstruction of complex defects. Plast Reconstr Surg 108(2):485–488

    Article  PubMed  CAS  Google Scholar 

  5. Sunar H, Aygit CA, Afsar Y, Halici U, Duran E (2004) Arterial and venous reconstruction for free tissue transfer in diabetic ischemic foot ulcers. Eur J Vasc Endovasc Surg 27(2):210–215

    Article  PubMed  CAS  Google Scholar 

  6. Nahabedian MY, Singh N, Deune G, Silverman R, Tufaro AP (2004) Recipient vessel analysis for microvascular reconstruction of the head and neck. Ann Plast Surg 52(2):148–155

    Article  PubMed  Google Scholar 

  7. Lin CH, Mardini S, Lin YT, Yeh JT, Wei FC, Chen HC (2004) Sixty-five clinical cases of free tissue transfer using long arteriovenous fistulas or vein grafts. J Trauma 56(5):1107–1117

    Article  PubMed  Google Scholar 

  8. Oswald TM, Stover SA, Gerzenstein J, Lei MP, Zhang F, Muskett A, Hu E, Angel MF, Lineaweaver WC (2007) Immediate and delayed use of arteriovenous fistulae in microsurgical flap procedures. Ann Plast Surg 58(1):61–63

    Article  PubMed  CAS  Google Scholar 

  9. Cavadas PC (2008) Arteriovenous vascular loops in free flap reconstruction of the extremities. Plast Reconstr Surg 121(2):514–520

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Plastic Surgery, Aristotle University of Thessaloniki, Thessaloníki, Greece

    Efterpi C. Demiri & Dimitrios Dionyssiou

  2. First Orthopaedic Department, Aristotle University of Thessaloniki, Thessaloníki, Greece

    Hippokratis Hatzokos & Angelos Megalopoulos

  3. Second Department of Surgery, Aristotle University of Thessaloniki, Thessaloníki, Greece

    Georgios Pitoulias & Dimitrios Papadimitriou

Authors
  1. Efterpi C. Demiri
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  2. Hippokratis Hatzokos
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  3. Dimitrios Dionyssiou
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  4. Angelos Megalopoulos
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  5. Georgios Pitoulias
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  6. Dimitrios Papadimitriou
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Correspondence to Efterpi C. Demiri.

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Demiri, E.C., Hatzokos, H., Dionyssiou, D. et al. Single stage arteriovenous short saphenous loops in microsurgical reconstruction of the lower extremity. Arch Orthop Trauma Surg 129, 521–524 (2009). https://doi.org/10.1007/s00402-008-0745-0

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  • DOI: https://doi.org/10.1007/s00402-008-0745-0

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