Arch Hand Microsurg 2019; 24(2): 177-182  
Free Latismus Dorsi Muscle Flap with a Flow-Through Technique for Lower Limb Salvage
Wael M. Ayad, Abdelnaser Hamdi Mohammed, Hany M. Ismail, Mohamed Osama Ouf, Amr M. Elbatawy
Department of Plastic and Burn Surgery, Al Azhar University, Cairo, Egypt
Correspondence to: Amr M. Elbatawy
Department of Plastic and Burn Surgery, Al Azhar University, 148 Elsad st., Cairo 11511, Egypt
TEL: +20-1113033384, FAX: +20-25326791, E-mail: Amrelbatawy@azhar.edu.eg, ORCID: https://orcid.org/0000-0003-2562-7291
Received: July 25, 2018; Revised: January 6, 2019; Accepted: March 12, 2019; Published online: June 1, 2019.
© Korean Society for Surgery of the Hand, Korean Society for Microsurgery, and Korean Society for Surgery of the Peripheral Nerve. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Purpose: The lower limb injuries still one of the devastating problems in surgical practice. Complex defects may affect one major vessel that supplies the distal portion of the leg and foot. The use of the flow-through technique is a very useful tool for sure vascularization of the flap and revascularization of the distal limb at the same time. The aim of this study was to evaluate the advantages of the use of the flow-through technique for lower limb reconstruction.
Methods: This retrospective study was including 15 patients complaining of post-traumatic leg and/or foot defects. Free latissimus muscle transfer with the flow-through technique was done for lower limb reconstruction. The subscapular artery was anastomosed to the proximal segment of the limb vessel and the circumflex scapular artery anastomosed to the distal segment of the limb vessel. Follow-up was for six months.
Results: Patients were followed for 6 months. All flaps were survived and there were no anastomotic complications.
Conclusion: The use of the flow-through technique is a very useful tool for vascularization of the flap and revascularization of the distal limb at the same time.
Keywords: Free tissue transfer flaps, Lower limb, Reconstructive surgical procedure, Microsurgical free flap


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