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- W4379508750 abstract "Abstract Objectives Iatrogenic injury of the fibula free flap pedicle is rare. Postoperative flap survival and reconstructive outcomes following intraoperative pedicle severance are unknown. This study assesses free flap outcomes following accidental severance of the peroneal vessels. Methods Multi‐institutional retrospective chart review from 2000 to 2020. Results Of 2975 harvested fibula free flaps, 26 had a history of pedicle severance during surgical reconstruction. Reasons for intraoperative pedicle severance included transection during muscular dissection 10/26 (39%), accidental severance with the bone saw 12/26 (46%), and other 4/26 (15.6%). The surgeon responsible for pedicle severance included residents 5/26 (19%), fellows 10/26 (39%), attendings 10/26 (39%), and unknown 1/26 (3.9%). The pedicle artery and vein were severed 10/26 (39%), artery 8/26 (31%), and vein 8/26 (31%). Truncated pedicle vessels were used 3/26 (11.7%), intraoperative anastomoses were performed 23/26 (89%). Postoperative revision in the OR within 7 days of surgery was required 6/26 (23%); 4 flaps were salvaged and 2 flaps failed, both arterial thrombosis. Flap failure was attributed to vascular thrombosis. Long‐term flap survival and successful reconstructions were reported 24/26 (92%). Conclusion Accidental severance of fibula free flap pedicle vessels can be corrected with intraoperative repair, without affecting long‐term flap survival or reconstructive outcomes. Protecting the flap vessels while using the bone saw and during intramuscular dissection prevents accidental severance." @default.
- W4379508750 created "2023-06-07" @default.
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- W4379508750 date "2023-06-05" @default.
- W4379508750 modified "2023-10-17" @default.
- W4379508750 title "Clinical outcomes following intraoperative pedicle disruption in fibula free flaps" @default.
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- W4379508750 doi "https://doi.org/10.1002/hed.27423" @default.
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