Manejo y reconstruccion microquirúrgica de extremidad inferior distal con colgajo SCIP libre

Abstract

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. (English) [ABSTRACT FROM AUTHOR]