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Percutaneous transluminal ballooning angioplasty for flap salvage in a complex lower extremity reconstruction

Title
Percutaneous transluminal ballooning angioplasty for flap salvage in a complex lower extremity reconstruction
Authors
Lee S.Y.Seong I.H.Park B.Y.
Ewha Authors
박보영
SCOPUS Author ID
박보영scopus
Issue Date
2020
Journal Title
Plastic and Reconstructive Surgery - Global Open
ISSN
2169-7574JCR Link
Citation
Plastic and Reconstructive Surgery - Global Open
Publisher
Lippincott Williams and Wilkins
Indexed
SCOPUS scopus
Document Type
Article
Abstract
The treatment of lower extremity trauma with extensive soft tissue defects requires a multidisciplinary approach. Following precise bone fixation, appropriate soft tissue reconstruction is a major requisite. We present a case of a severe lower extremity injury caused by an excavator bucket that fell on the patient's foot, which was reconstructed with multiple perforator flaps after concise bone fixation. During the treatment, we repeatedly experienced threatened flaps, which could not be recovered with emergent re-explorations. Although vascular occlusion after a free flap surgery may be rare, it poses a major challenge. It necessitates urgent re-exploration, but there are logistical challenges with providing sufficient resources for endovascular revascularization. We attempted an immediate postoperative angioplasty after the failure of surgical re-exploration as a salvage option and achieved successful flap survival. As the flap completely survived without complications, the patient could walk, with bearing his full weight without the use of any orthosis. Despite the development of new techniques for flap revision, which have increased the possibility of limb salvage, immediate postoperative endovascular revascularization can be considered as a salvage option in cases of a compromised flap. © 2020 The Authors.
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DOI
10.1097/GOX.0000000000003077
Appears in Collections:
의과대학 > 의학과 > Journal papers
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