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Cirugía Plástica Ibero-Latinoamericana

versão On-line ISSN 1989-2055versão impressa ISSN 0376-7892

Resumo

MALAGON LOPEZ, Paloma et al. Management and microsurgical reconstruction of distal lower limb with SCIP free flap. Cir. plást. iberolatinoam. [online]. 2019, vol.45, n.2, pp.189-195.  Epub 14-Out-2019. ISSN 1989-2055.  http://dx.doi.org/10.4321/s0376-789220190002000012.

Background and objetive

New reconstruction techniques have been described for last years with good aesthetic and functional results, such as the free SCIP flap (Superficial Circumflex Iliac Artery Perforator). Supermicrosurgery allows anastomoses to perforator vessels and therefore the main vessels of the limb can be preserved.

The aim of this study is to present our experience in the reconstruction of the distal lower extremity with free SCIP and its perioperative management.

Methods

From 2015 to 2017, 17 patients who underwent a reconstruction of the distal lower extremity (leg and foot) by free SCIP flap were included. Preoperative CT-angiography was performed for the surgical planning and to assess the need for angioplasty.

Results

End-to-end anastomoses were made to perforator vessels of the recipient area. No immediate microsurgical revisions were needed. The most frequent postoperative complication was venous congestion (29.4%). Limb salvage was achieved in all patients and walk ability was preserved.

Conclusions

The free SCIP flap is a good microsurgical option for the reconstruction of the distal lower extremity, both aesthetically and functionally, presents few complications and can avoid amputation. Based on our initial experience, we recommend performing a CT-angiography and a preoperative assessment of regional vascularization optimization, postural changes, 2 venous anastomoses whenever possible and multidisciplinary management.

Palavras-chave : SCIP; Lower extremity; Perforator flaps; Free flaps.

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