Wo. Thomas et al., MANAGEMENT OF EXPOSED INGUINOFEMORAL ARTERIAL CONDUITS BY SKELETAL MUSCULAR ROTATIONAL FLAPS, The American surgeon, 60(11), 1994, pp. 872-880
Peripheral vascular reconstructions are common operations for the trea
tment of occlusive atherosclerosis, and the vast majority are uncompli
cated. However, despite all precautionary measures, a small percentage
of patients will manifest wound infection and graft exposure that may
evolve to loss of limb and/or life. Treatment has traditionally consi
sted of systemic administration of antibiotic medication(s), graft ext
irpation, and extra-anatomic arterial bypass; yet despite use of these
more radical modalities, morbidity and mortality have remained high.
An additional meritorious adjunct for the treatment of exposed prosthe
tic or autogenous saphenous vein arterial bypass grafts is the use of
local/regional autogenous skeletal muscular rotational flaps. Reported
herein are the results of this technique applied to the inguinofemora
l regions of eight patients. Rectus abdominis (1 patient), rectus femo
ris (4), and sartorius (4) skeletal muscular rotational flaps were emp
loyed. Seven of eight (88%) patients convalesced well at mean duration
of follow-up measuring 24 months, although one patient subsequently r
equired major amputation due to progression of occlusive atheroscleros
is. One of eight (12%) patients succumbed secondary to irreversible se
psis, despite radical amputation. The data suggest that use of local/r
egional skeletal muscular rotational flaps is a useful adjunct for the
treatment of patients with exposed arterial conduits.