Rectus Femoris Flap Research Articles

Experience with femoro-popliteal vein as a conduit for vascular reconstruction in infected fields

Objective: to review the outcome of femoro-popliteal vein grafts for arterial reconstruction in the presence of sepsis. Patients and Methods: twenty-six patients underwent 27 arterial reconstructions with femoro-popliteal vein in the presence of infection. Five had mycotic aneurysms (3 aortic, 1 iliac and 1 femoral), 21 had prosthetic graft infections (9 aortic, 8 femoro-femoral, 2 axillo-femoral, 1 ilio-femoral and 1 femoral dacron patch) and one underwent superior mesenteric artery reconstruction following ischaemic small bowel perforation. Arterial reconstruction followed debridement of infected tissue, removing any infected graft, povidone iodine washout and appropriate antibiotic cover. Where possible, new grafts were placed in a clean field or wrapped in omentum. Four femoral anastomoses were covered by rectus femoris flaps. Results: there was one early postoperative death (4%) and no limb loss. All others remained free from infection with patent grafts at 1 month to 5 years (median 22 months). Three major wound infections healed without exposing the graft. One infarcted rectus femoris flap required removal. Donor limb swelling was transient. Five required percutaneous angioplasty and one underwent open profundaplasty within 3 months. Conclusion: femoro-popliteal vein reconstruction with debridement and appropriate antibiotic therapy is recommended for the treatment of arterial or graft infections.Eur J Vasc Endovasc Surg 25, 424-431 (2003)

Neurovascular anatomy of the rectus femoris flap in the rabbit.

The rectus femoris muscle in the rabbit represents a reliable flap for experimental work in many aspects of microsurgery. The operative exposure of the flap is often tricky for those unfamiliar with the anatomy, as is isolation of its neurovascular pedicle. Experience with 59 consecutive rectus femoris flaps demonstrated five separate patterns of arteral and venous pedicles. The nervous anatomy was found to be constant. Once recognized, these vessel patterns can be used to facilitate pedicle dissection, thus minimizing intraoperative mistakes which may endanger the viability of the flap.

Warning About the Use of Rectus Femoris Flaps in Patients with Previous Surgery for Congenital Hip Dislocation

Warning About the Use of Rectus Femoris Flaps in Patients with Previous Surgery for Congenital Hip Dislocation

Oromandibular reconstruction using a third free flap in sequence in recurrent carcinoma

Successful results of a second microsurgical reconstructive attempt have been reported previously in recurrent oral carcinoma. However, the feasibility of a third free flap following a third excision has remained to be determined. Six oral carcinoma patients with multiple recurrences, surgical excisions and free flap reconstructions on three separate occasions are presented. Resections had a curative intent in all cases in the first and second ablations and in four of the six cases in the third one. Five radial forearm flaps and one double free flap were used for the first reconstruction. During the second reconstruction two radial forearm, two fibula osteoseptocutaneous, one double free flap and one rectus femoris flap were used to reconstruct the larger defects resulting from excision of the recurrent tumours. However, no vascularised bone transfers were performed following the third excision and soft tissue free flap plus plate option was used for segmental mandibular defects. There was one partial flap loss among 21 free flaps performed. Three patients died within an average of 8 months following the third reconstruction while the others remained alive, surviving an average of 6 months. In conclusion, a third free tissue transfer for reconstruction in multiply recurrent oral carcinoma was found to be feasible, safe and effective. The use of free flaps contributed to the prevention of complications in these difficult cases and enabled the patients to spend the remaining days of their lives outside hospital.

Abdominal Wall Reconstruction with an Expanded Rectus Femoris Flap

The expanded rectus femoris flap has several advantages for massive abdominal wall reconstruction. The expanded flap can easily reach the xyphoid, and it has impressive width. The donor site can be closed primarily with an acceptable scar. The muscle remains innervated and functional, which may help prevent bulging. When performing the surgery in conjunction with intra-abdominal procedures, such as fistula repair, a simultaneous two-team approach can be used without awkward positioning. The expansion provides some thinning of the muscle, providing a contour more like that of the native abdomen. Its use should be considered in cases of abdominal wall defects extending above the umbilicus.

Abdominal Wall Reconstruction (the “Mutton Chop” Flap)

Reconstruction of full-thickness abdominal wall defects can be a difficult surgical challenge. Reconstructing the epigastrium may be especially vexing. The use of prosthetic mesh has significant drawbacks, and the use of pedicled myofascial and myocutaneous flaps should be advantageous. We present 15 consecutive cases demonstrating highly successful reconstructions of massive abdominal wall defects using myofascial and myocutaneous flaps without prosthetic mesh. The extended rectus femoris flap, or "mutton chop" flap, which is capable of resurfacing the epigastrium, is described. Complications were minimal, and use of myofascial units, particularly the rectus femoris, should be considered as the technique of choice for reconstruction of major abdominal wall deficits.