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Arch Hand Microsurg > Volume 23(2); 2018 > Article
Archives of Hand and Microsurgery 2018;23(2):121-125.
Published online June 1, 2018.
DOI: https://doi.org/10.12790/ahm.2018.23.2.121   
An Iatrogenic Flap Necrosis Case: Factors to Consider for Successful Flap Elevation
Non Hyeon Ha, Ill Jae Lee
Department of Plastic and Reconstructive Surgery, Ajou University School of Medicine, Suwon, Korea. i00325@live.co.kr
Received: 9 April 2018   • Revised: 5 May 2018   • Accepted: 14 May 2018
Abstract
The free flap technique has been used for lower limb reconstruction. Still, the free flap itself and related surgical procedures are challenging process, because there's a lot of factors to consider for successful outcome. We report a case of total flap necrosis due to inadequate flap elevation on the left ankle of a young man. Although the shape of the elevated flap was not fit into rectangular shape exactly, the length to width ratio of the flap was almost 2.25:1. The circulation to the tissue was not enough to flap survival, due to inadequate incision. To prevent flap mismanagement, all the surgical procedure should be performed based on a thorough understanding of flap related knowledge, such as length-width ratio restriction of elevated flap, angiosome and proper surgical incision. Also we recommend swell-timed consultation with surgeons trained in microsurgery for guidance regarding flap evaluation and its subsequent management.
Key Words: Free flaps, Microsurgery, Lower extremity, Angiosome
 
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