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교차하지 (Cross-Leg Fashioned) 유리 근육피판술의 신생혈관 형성에 관한 고찰

Other Titles
 Neovascularization in the "Cross-Leg Fashioned" Muscular Free Flap 
 이혜경  ;  서만군  ;  박철  ;  탁관철 
 Journal of the Korean Society of Plastic and Reconstructive Surgery (대한성형외과학회지), Vol.26(4) : 617-625, 1999 
Journal Title
Journal of the Korean Society of Plastic and Reconstructive Surgery(대한성형외과학회지)
Issue Date
For the reconstruction of soft tissue defect combined with open fracture in the lower leg, free flap, especially muscle free flap which has abundant blood supply, is considered to be the most suitable method. Sometimes, however, injury to the main vessels in the lower leg makes it impossible to use a principal vessel as a recipient vessel. In such cases, vein graft or end-to-side anastomosis can be employed. To acquire a healthier vessel as a recipient,the authors performed crossleg muscle free flap, using a non-injured healthy vessel of the contralateral leg as a recipient vessel. Controversy still lingers over the angiogenesis of cross-leg muscle free flap and thus safety after flap detachment. There have been some clinical case reports on cross-leg muscle free flap, but flap survival after pedicle detachment has been known to be variable according to different authors. Because of the uncertainty of neovascularization in muscular free flap at the time of flap delay procedure,many surgeons hesitate to use a pure muscle free flap as a delay flap. Eight cases of cross-leg muscular free flap were performed by the authors using the rectus abdominis muscle, latissimus dorsi muscle and a combination of the latissimus dorsi and serratus anterior muscle flap. During the operation, the authors estimated the ratio of poorly vascularized bed in recipient soft tissue defect. Despite the high ratio of non-vascularized bed, there was no flap necrosis after pedicle detachment and ample neovascularization within the muscle was confirmed by post-division angiogran. As well, there was no recurrence of osteomyelitis. Conclusively, enough neovascularization in cross-leg free muscle flap, even placed on a poorly vascularized bed, could be induced through a delayed procedure.
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1. College of Medicine (의과대학) > Dept. of Plastic and Reconstructive Surgery (성형외과학교실) > 1. Journal Papers
Yonsei Authors
Tark, Kwan Chul(탁관철)
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