Learn about new offers and get more deals by joining our newsletter. Utilizing AV loops to support transferred free flaps upper limb defects showed a promising successful outcome. Results of combined vascular reconstruction and free flap transfer for limb salvage in patients with critical limb ischemia. As the camera moves from one viewpoint to another, the specimen appears to rotate in space, letting the viewer experience it as a three dimensional object. Click here to view. Around 4 months later, she underwent microsurgical flap transfer of the second fibula to the right forearm. Free flap selection depends on size, depth and mechanism of injury, exposed structures, and surrounding tissues.
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She underwent debridement of the necrotic tissue, ulnar artery repair, and bone stabilization by inserting 2 Kirschner wires K-wires between the hand and forearm. We utilized the long saphenous vein to construct an AV loop, which was anastomosed end-to-side with the brachial artery and end-to-end with the basilic vein.
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However, the proximal part of the radial artery was avulsed by the injury, blood flow to the flap was weak, and thrombosis occluded the vessel; hence the flap did not survive. At postoperative day 16, split-thickness skin graft was utilized to close the defect. Published online Nov We present a case with a devastating upper limb crush injury that was successfully managed with fibula flap transfer preceded by AV loop construction.
Undergraduate study Find a course Open days and visits New undergraduate students. Refinements in lower extremity free flap surgery. Our patient was followed up with subjective, objective, and radiographic assessment. Significant psychological consequences follow limb amputation. She underwent multiple staged operations beginning with repair of the ulnar artery, debridement of necrotic tissue, and placement of 2 K-wires to stabilize the bones.
However, the flap did not survive and was removed 3 days later. Gastroenterology Nursing Test Drive. Often, in the defect vicinity, local tissues are insufficient to achieve effective and adequate coverage.
Find a study space. Medline on OvidSP – covers the international literature on bioMedicine, including the allied health fields and the biological and physical sciences, humanities, and information science as they relate to Medicine and health care. Constructing arteriovenous AV loops saves a crushed limb when healthy recipient vessels are unavailable at the site of injury by supporting a transferred free flap. The loop was connected to the flap pedicle through end-to-end anastomosis. Historical Anatomies on the Web – access to high quality images from important anatomical atlases in the collection of the National Library of Medicine.
Arteriovenous loop grafts for free tissue transfer. As each new structure is shown, its name appears on the screen.
This loop was long enough to prevent any tension during upper limb movement. The authors have no financial interest to declare in relation to the content of this article.
A year-old Palestinian woman, who was previously healthy, was referred to Bethlehem Arab Society for Rehabilitation Hospital with severe crush injury to her right upper limb after it was trapped into a wheat processing machine.
There was significant skin loss with injuries to blood vessels and tendons.
Further operations to reconstruct her extensor tendons and carpal bones, and to debulk the fibula, and physiotherapy sessions would improve her hand function. Single-stage versus two-stage xcland loop microsurgical reconstruction: J Bone Joint Surg Am.
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Free Flap Transfer with Arteriovenous Loop Establishment for Upper Limb Salvage in a Crush Injury
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Composite tissue transfer in upper extremity trauma. The work cannot be changed in any way or used commercially without permission from the journal.