KMID : 1038220220490060782
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Archives of Plastic Surgery 2022 Volume.49 No. 6 p.782 ~ p.784
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Extracorporeal Pedicles for Free Flap Reconstruction in Diabetic Lower Extremity Wounds
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Gimenez Alejandro R.
Maricevich Marco Lazo Daniel Chade Salomao Fioravanti Alex Colicchio Olimpio Alvarez Daniel Junior Ernani Raj Sarth Ghname Amjed Abu
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Abstract
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Diabetic foot ulcers are a severe complication of diabetes, and their management requires a multidisciplinary approach for optimal management. When treating these ulcers, limb salvage remains the ultimate goal. In this article, we present the ¡°hanging¡± free flap for the reconstruction of chronic lower extremity diabetic ulcers. This two-staged approach involves standard free flap harvest and inset; however, following inset the ¡°hanging¡± pedicle is covered within a skin graft instead of making extraneous incisions within the undisturbed soft tissues or tunnels that can compress the vessels. After incorporation, a second-stage surgery is performed in 4 to 6 weeks which entails pedicle division, flap inset revision, and end-to-end reconstruction of the recipient vessel. Besides decreasing the number of incisions on diabetic patients, our novel technique utilizing the ¡°hanging¡± pedicle simplifies flap monitoring and inset and allows reconstruction of recipient vessels to reestablish distal blood flow.
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KEYWORD
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diabetic foot ulcers , hanging pedicle , microvascular reconstruction , free tissue transfer
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