Thursday, January 6, 2011

Limb Salvage with Free Rectus Muscle Flap

Occlusion of vessels of the leg can significantly impair wound healing when the integrity of the skin is violated. In the distal third of the leg where there is limited leg laxity, it is necessary to bring well vascularized tissue from one region of the body to another.

When one of the three blood vessels to the leg is occluded, it is important to maintain the remaining blood supply of the lower extremity. In that case, the rectus muscle is removed from the abdomen and transferred to the leg using and end-to-side anastamosis off of the posterior tibial vessel. Using an end-to-side anastamosis can preserve the blood supply to the foot.

Drains are placed beneath the muscle and the muscle is then covered with a split thickness skin graft. Elevation of the lower extremity is important post-operatively.