Combined Free Flaps in Reconstruction of Upper Extremity

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Journal of the Korean Society for Surgery of the Hand 2004;13(1):1-6.
Published online May 31, 2004.

Sug Won Kim, M.D., June Bok Lee, M.D., Sung Jun Lee, M.D., Chul Hwan Seul, M.D., Dong Wan Seo, M.D.

결합 유리피판을 이용한 상지 복합결손의 재건

김석원·이준복·이성준·설철환·서동완

Abstract

  Advances in microvascular techniques and refinements in microsurgical tissue transfers have enabled surgeons to combine different tissue components and reconstruction into a single-stage operation in extensive or composite defect following injury. Some problems and consideration for extensive or composite defects are form, shape, function, and dimension of the defect sites. Therefore combination of two or more flaps is required to reconstruct extensive or composite defect. This paper presents our clinical experience of four cases of combined free flaps with or without sequential microanastomosis in reconstruction of upper extremity based on peroneal flowthrough, thoracodorsal, and dorsalis pedis vascular system. Satisfactory results were obtained without flap loss and complications. The free flaps were combined in th following fashion; two cases by bridge fashion, one by chimeric microanastomosis and one by simple chimeric fashion. The median follow-up time on all patients was 21.7 months. Donor site morbidity was minimal. Extensive soft tissue or composite defects can be effectively covered by various combined flaps. Even though the risk for complication exists, the options of combination with or without sequential microanastomosis can add a functional or sensory dimension to reconstruction of complex wounds.

Key Words: Combined free flap, Upper extremity, Single-stage operation

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