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Does the use of arteriovenous loops increase complications rates in posttraumatic microsurgical lower extremity reconstruction?—A matched‐pair analysis
Author(s) -
Momeni Arash,
Lanni Michael A.,
Levin Lawrence S.,
Kovach Stephen J.
Publication year - 2018
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.30197
Subject(s) - medicine , surgery , dehiscence , complication , wound dehiscence , vein , body mass index , microsurgery , free flap
The use of arteriovenous (AV) loops in microsurgical lower extremity reconstruction is a controversial topic. The objective of the present study was to assess the impact of AV loops on complication rates following microsurgical reconstruction of posttraumatic lower extremity defects. Patients and Methods Patients who underwent free flap coverage of posttraumatic defects in combination with an AV loop (Group 1) were identified and matched for age, body mass index (BMI), tobacco use, defect location, and flap type with patients who underwent reconstruction without vein grafts (Group 2). Outcomes of interest included complication rate and flap loss rate. Results Groups 1 and 2 consisted of 10 patients each with a mean age of 51 years (range, 21–79 years) and 47.3 years (range, 22–69 years), respectively ( P = 0.596). No differences were noted regarding flap loss ( P = 1.0), intraoperative ( P = 0.474) or postoperative complication rate [surgical site infection ( P = 1.0), bleeding ( P = 1.0), delayed wound healing ( P = 0.23), dehiscence ( P = 0.58), and osseous non‐union ( P = 1.0)]. Only one flap loss was noted in Group 1. The only differences were increased operative time ( P = 0.03) and increased length of stay ( P = 0.009) in Group 1. Conclusion Our results suggest that utilization of vein grafts with creation of AV loops followed by single‐stage division and free flap transfer for reconstruction of posttraumatic lower extremity defects achieve reconstructive outcomes similar to those obtained in patients in whom no vein grafts are necessary.