Safe and Effective Method to Transfer Pedicle Vessels in Free Flap Reconstruction

Abstract

Free tissue transfer is a useful method to cover soft tissue defects following trauma or tumor excision. At the time of transfer of the pedicle, its status is not investigated. Therefore, kinking of the pedicle can occur, and pedicle injuries can result from surgical instruments. The authors would like to introduce a simple, safe, and effective method to overcome these problems using a Penrose drain. The present method can help reconstructive microsurgeons with the transfer of pedicle vessels through a tunnel without torsion or injury.

An Easy and Effective Method for Avoiding Intraoperative Pedicle Vessels Kinking

“…However, when manipulating long pedicles, such as an anterolateral thigh flap (Figure 1) or small-caliber pedicles as in flaps supported by perforators (i.e., vessels that penetrates the envelope of the tissue to be transferred; the superficial fascia for skin, the periosteum for bone, the perineurium for nerve, and the deep fascia for muscle) (Yamamoto et al, 2019), this technique can jeopardize the viability of the pedicle and, consequently, of the flap. Although several techniques to avoid pedicle kinking have been described in the literature (Scaglioni et al, 2016; Yi et al, 2017), we introduce a new method for avoiding pedicle tension that does not require elaborate surgical maneuvers and can be easily performed in the operating room.…”