Free fillet lower leg flap with fenestration of the pelvis as prevention of vascular problem after hemipelvectomy.

DVOŘÁK, Zdeněk, Tomáš TOMÁŠ, Martin KUBÁT, Vasileios APOSTOLOPOULOS and Nzinga TAWA. Free fillet lower leg flap with fenestration of the pelvis as prevention of vascular problem after hemipelvectomy. Journal of plastic, reconstructive & aesthetic surgery. OXFORD: ELSEVIER SCI LTD, 2022, vol. 75, No 8, p. 2845-2847. ISSN 1748-6815. Available from: https://dx.doi.org/10.1016/j.bjps.2022.06.071.

Basic information

• Original name: Free fillet lower leg flap with fenestration of the pelvis as prevention of vascular problem after hemipelvectomy.
• Authors: DVOŘÁK, Zdeněk (203 Czech Republic, guarantor, belonging to the institution), Tomáš TOMÁŠ (203 Czech Republic, belonging to the institution), Martin KUBÁT (203 Czech Republic, belonging to the institution), Vasileios APOSTOLOPOULOS (203 Czech Republic, belonging to the institution) and Nzinga TAWA.
• Edition: Journal of plastic, reconstructive & aesthetic surgery, OXFORD, ELSEVIER SCI LTD, 2022, 1748-6815.

Other information

• Original language: English
• Type of outcome: Article in a journal
• Field of Study: 30212 Surgery
• Country of publisher: United Kingdom of Great Britain and Northern Ireland
• Confidentiality degree: is not subject to a state or trade secret
• WWW: URL
• Impact factor: Impact factor: 2.700
• RIV identification code: RIV/00216224:14110/22:00128865
• Organization unit: Faculty of Medicine
• Doi: http://dx.doi.org/10.1016/j.bjps.2022.06.071
• UT WoS: 001160464600008
• Keywords in English: Free fillet lower leg flap; pelvis; fenestration; hemipelvectomy; vascular problem
• Tags: International impact, Reviewed

Abstract

We read with great interest the article by L. Kreutz-Rodrigues et al. from Mayo Clinic: Reconstruction of complex hemipelvectomy defects: a 17-year single-institutional experience with lower extremity free and pedicled flaps1. Congratulations to the authors for the excellent results and for including the largest published group of patients to date. We completely agree with the harvesting technique as described by the authors. We believe that the elevation of the flap with fibula is faster and in addition the fibula can be used to reconstruct the pelvic ring. Certainly, double-team surgery is standard for time-saving and minimising the ischaemia time. However, we consider the use of a pedicled flap with rotation of the pedicle in the pelvis or bending of the vascular pedicle around the edge of iliac crest too risky. It can cause venous thrombosis, as described by Kreutz-Rodrigues et al.1. Previous studies have reported the occurrence of venous thrombosis in three out of seven cases. We propose a technique where the vascular pedicle can be inserted into the pelvis through a bone window, allowing for successful vascular anastomosis without any vascular complications.