Microsurgical reconstruction of extensive lower extremity defects with the conjoined parascapular and latissimus dorsi free flap
Background Extensive lower extremity soft-tissue defects pose a reconstructive challenge. We present our experience with the conjoined parascapular and latissimus dorsi (CPLD) free flap. Methods From October 2008 to October 2017, 69 patients (14 female, 55 male) with a mean age of 50 years (range: 1...
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| Hauptverfasser: | , , , , , |
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| Dokumenttyp: | Article (Journal) |
| Sprache: | Englisch |
| Veröffentlicht: |
21. August 2020
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| In: |
Microsurgery
Year: 2020, Jahrgang: 40, Heft: 6, Pages: 639-648 |
| ISSN: | 1098-2752 |
| DOI: | 10.1002/micr.30640 |
| Online-Zugang: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1002/micr.30640 Verlag, lizenzpflichtig, Volltext: https://onlinelibrary.wiley.com/doi/abs/10.1002/micr.30640 
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| Verfasserangaben: | Amir K. Bigdeli, Benjamin Thomas, Florian Falkner, Christian A. Radu, Emre Gazyakan, Ulrich Kneser |
| Zusammenfassung: | Background Extensive lower extremity soft-tissue defects pose a reconstructive challenge. We present our experience with the conjoined parascapular and latissimus dorsi (CPLD) free flap. Methods From October 2008 to October 2017, 69 patients (14 female, 55 male) with a mean age of 50 years (range: 16-79 years) underwent reconstruction of lower extremity defects with the CPLD free flap. Mean defect size was 24 × 36 cm (range: 14 × 20 to 45 × 80 cm). Results Mean latissimus dorsi (LD) flap size was 19 × 28 cm (range: 14 × 20 to 28 × 42 cm) and mean parascapular (PSC) flap size was 8 × 25 cm (range: 5 × 12 to 11 × 33 cm). Six patients (9%) experienced a total of eight microvascular complications: arterial thrombosis (n = 1), venous thrombosis (n = 6), combined arterial and venous thrombosis (n = 1). The re-exploration rate was 13%. Major complications of the donor-site were seen in 9 patients (13%), of the flap in 13 patients (19%), and of both in 6 patients (9%). Fifteen patients experienced partial flap necrosis (22%). Three CPLD and one PSC flap were lost (5%). PSC flap length was a significant predictor of distal flap necrosis (χ2(1) = 13.2, p = .004, OR = 1.343, 95% CI [1.098-1.642]). PSC flap width was a significant predictor of donor-site revisions (χ2(1) = 15.9, p = .010, OR = 4.745, 95% CI [1.584-14.213]). Arterio-venous loops (AVLs) tended to increase the risk of microvascular thrombosis (χ2(1) = 3.7, p = .08, OR = 4.1, 95% CI [0.9-18.7]). Conclusions The CPLD free flap is an extremely large and highly reliable flap, allowing one-stage reconstruction of extensive lower extremity defects. It may overcome the need for multiple flaps in selected cases. |
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| Beschreibung: | Gesehen am 23.03.2026 |
| Beschreibung: | Online Resource |
| ISSN: | 1098-2752 |
| DOI: | 10.1002/micr.30640 |