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A novel salvage approach for pedicle axial flap—free‐ization of pedicle internal mammary artery perforator flap
Author(s) -
Chen WeiFan,
Tsao ChungKan,
Cheng MingHuei
Publication year - 2012
Publication title -
microsurgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.031
H-Index - 63
eISSN - 1098-2752
pISSN - 0738-1085
DOI - 10.1002/micr.21962
Subject(s) - medicine , surgery , debridement (dental) , microsurgery , free flap , perforator flaps , blood supply , mammary artery , artery , anatomy
A pedicle flap with distal segment compromise is classically managed by allowing tissue demarcation, debridement of non‐viable tissue, and local tissue manipulation to achieve wound closure. When aggressive debridement leaves insufficient tissue for defect coverage, the original flap is often discarded. We present a case of distal necrosis of a pedicle internal mammary artery perforator flap for cheek reconstruction. The flap, which was rendered too small after debridement for defect coverage in its pedicle form, was converted to a free flap. The technical details of such conversion and potential feasibility of applying this conversion to other compromised pedicle flaps are discussed. We hypothesized that the principle of “free‐ization” can be applied effectively for salvage of other failing pedicle flaps with axial blood supply. © 2012 Wiley Periodicals, Inc. Microsurgery, 2012.