Late partial failure of a free ALT flap

• Published in: Journal of plastic, reconstructive & aesthetic surgery Vol. 65; no. 5; pp. e124 - e127
• Main Authors: Pignatti, Marco, Iwuagwu, Fortune C, Browne, Tom F
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01-05-2012
• Subjects: Accidental Falls; Anastomosis, Surgical; Debridement; Fibula - injuries; Fracture Fixation, Internal - methods; Fractures, Open - surgery; Free Tissue Flaps; Free-flap complications; Graft Rejection; Humans; Late failure; Leg Injuries - surgery; Male; Microsurgery; Middle Aged; Plastic Surgery; Postoperative Complications - surgery; Risk Factors; Thigh; Tibial Fractures - surgery; Vascular Surgical Procedures - methods; Microsurgery; Free-flap complications; Late failure
• ISSN: 1748-6815; 1878-0539
• DOI: 10.1016/j.bjps.2011.11.057

Summary Late failure of microsurgical flaps is a rare event and it has been reported as a consequence of compression of the vascular pedicle or late infection. We report a case of late partial failure occurring 3 weeks post-operatively which was shown by vascular imaging to be caused by a previously unidentified complete occlusion of the right external iliac artery. After successful vascular bypass surgery, the suffering flap developed granulation tissue and was skin grafted. In patients carrying multiple risk factors for peripheral vascular disease, the risk of proximal vessel occlusion as a cause of flap failure, should be kept in mind.