Combined Vascular Reconstruction, Vacuum-Assisted Closure and Free Flap Transfer for Limb Salvage

• Igari Kimihiro

  Division of Vascular Surgery, Department of Surgery, Tokyo Medical and Dental University

• Tanaka Kentaro

  Department of Plastic Surgery, Tokyo Medical and Dental University

• Kudo Toshifumi

  Division of Vascular Surgery, Department of Surgery, Tokyo Medical and Dental University

• Toyofuku Takahiro

  Division of Vascular Surgery, Department of Surgery, Tokyo Medical and Dental University

• Jibiki Masatoshi

  Division of Vascular Surgery, Department of Surgery, Tokyo Medical and Dental University

• Inoue Yoshinori

  Division of Vascular Surgery, Department of Surgery, Tokyo Medical and Dental University

Bibliographic Information

Other Title

• 重症虚血肢に対する下肢血行再建術，持続陰圧吸引療法と遊離筋皮弁術による集学的治療

Abstract

Critically ischemic limbs with extensive tissue loss may be candidates for major amputation. However, aggressive therapy, which was bypass surgery with free flap transfer, can reduce the need for major amputation. We report two cases of ischemic limb with tissue loss, which were treated successfully with bypass surgery, vacuum-assisted closure and free flap transfer. Case 1: A patient with tissue loss around left heel, firstly underwent bypass surgery and debridement of the heel. The heel wound was treated with vacuum-assisted closure therapy, accelerating granulation. After that, free flap transfer was performed with covering split-thickness skin graft. Case 2: A patient with right plantar tissue loss first underwent bypass surgery and debridement. The wound plantar was treated with vacuum-assisted closure therapy, accelerating granulation. After that, free flap transfer was performed with covering split-thickness skin graft. A multidisciplinary approach for ischemic limbs with tissue loss can provide excellent results, and this procedure should be considered in patients with extensive tissue loss before amputation is performed.

Journal

• Japanese Journal of Vascular Surgery

  Japanese Journal of Vascular Surgery 21 (6), 757-761, 2012

  JAPANESE SOCIETY FOR VASCULAR SURGERY

Keywords

• Critical limb ischemia
• Distal bypass surgery
• Vaccum-assisted closure
• Free flap transfer

Details

• CRID: 1390001204414314624
• NII Article ID: 130004843122
• DOI: 10.11401/jsvs.21.757
• ISSN: 1881767X
• ISSN: 09186778
• Web Site: https://search.jamas.or.jp/link/ui/2013027571
• Text Lang: ja
• Data Source:
  • JaLC
  • CiNii Articles
  • KAKEN
• Abstract License Flag: Disallowed